| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $169.82 | $977.24 | $1,819.70 |
Aetna
| Professional | QZ | $524.81 | $645.65 | $645.65 |
Ambetter
| Professional | AA | $120.23 | $229.09 | $457.09 |
Ambetter
| Professional | QZ | $120.23 | $199.53 | $457.09 |