| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $549.54 | $912.01 | $1,412.54 |
Aetna
| Professional | QZ | $173.78 | $575.44 | $1,174.90 |
Ambetter
| Professional | AA | $158.49 | $229.09 | $724.44 |
Ambetter
| Professional | QZ | $154.88 | $177.83 | $758.58 |