| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,288.25 | $2,187.76 | $2,951.21 |
Aetna
| Professional | QZ | $1,862.09 | $1,862.09 | $1,862.09 |
Ambetter
| Professional | AA | $371.54 | $1,288.25 | $1,737.80 |
Ambetter
| Professional | QZ | $316.23 | $316.23 | $426.58 |