| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $602.56 | $1,071.52 | $1,548.82 |
Aetna
| Professional | QZ | $173.78 | $954.99 | $1,174.90 |
Ambetter
| Professional | AA | $138.04 | $138.04 | $181.97 |
Ambetter
| Professional | QZ | $162.18 | $223.87 | $316.23 |