| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $843.88 | $1,144.34 | $1,287.00 |
Aetna
| Professional | QZ | $833.19 | $901.41 | $959.70 |
Ambetter
| Professional | AA | $290.55 | $697.32 | $1,273.00 |
Ambetter
| Professional | QZ | $461.01 | $707.97 | $1,375.00 |