| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $851.14 | $1,258.93 | $1,949.84 |
Aetna
| Professional | QZ | $173.78 | $954.99 | $1,174.90 |
Ambetter
| Professional | AA | $120.23 | $120.23 | $245.47 |
Ambetter
| Professional | QZ | $158.49 | $177.83 | $263.03 |