| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $326.04 | $326.04 | $403.07 |
Aetna
| Professional | QZ | $660.00 | $660.00 | $660.00 |
Ambetter
| Professional | AA | $98.95 | $154.57 | $480.00 |
Ambetter
| Professional | QZ | $351.05 | $351.05 | $351.05 |