| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $466.69 | $900.00 | $1,540.00 |
Aetna
| Professional | QZ | $416.60 | $416.60 | $837.00 |
Ambetter
| Professional | AA | $154.88 | $158.32 | $174.33 |
Ambetter
| Professional | QZ | $135.52 | $247.38 | $519.36 |