| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $436.52 | $2,454.71 | $3,162.28 |
Aetna
| Professional | QZ | $912.01 | $912.01 | $3,311.31 |
Ambetter
| Professional | AA | $489.78 | $616.60 | $1,348.96 |
Ambetter
| Professional | QZ | $354.81 | $977.24 | $1,513.56 |