| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $616.60 | $660.69 | $1,445.44 |
Aetna
| Professional | QZ | $46.77 | $446.68 | $676.08 |
Ambetter
| Professional | AA | $158.49 | $177.83 | $208.93 |
Ambetter
| Professional | QZ | $154.88 | $194.98 | $213.80 |