| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $707.95 | $1,122.02 | $1,548.82 |
Aetna
| Professional | QZ | $173.78 | $954.99 | $1,174.90 |
Ambetter
| Professional | AA | $177.83 | $354.81 | $1,000.00 |
Ambetter
| Professional | QZ | $154.88 | $194.98 | $213.80 |