| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $867.00 | $867.00 | $939.25 |
Ambetter
| Professional | AA | $721.14 | $721.14 | $721.14 |
Ambetter
| Professional | QZ | $360.57 | $550.00 | $889.20 |
Qualchoice
| Professional | AA | $506.00 | $506.00 | $506.00 |
Qualchoice
| Professional | QZ | $414.66 | $632.50 | $1,022.58 |