| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $466.10 | $1,120.00 | $2,100.00 |
Aetna
| Professional | QZ | $363.60 | $363.60 | $716.28 |
Ambetter
| Professional | AA | $238.10 | $394.38 | $747.46 |
Ambetter
| Professional | QZ | $1,174.58 | $1,174.58 | $1,174.58 |