| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $843.88 | $920.59 | $1,900.00 |
Aetna
| Professional | QZ | $833.19 | $901.41 | $959.70 |
Ambetter
| Professional | AA | $290.55 | $435.38 | $697.32 |
Ambetter
| Professional | QZ | $361.08 | $544.23 | $1,288.00 |