| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $562.34 | $1,096.48 | $1,621.81 |
Aetna
| Professional | QZ | $575.44 | $794.33 | $870.96 |
Ambetter
| Professional | AA | $323.59 | $323.59 | $851.14 |
Ambetter
| Professional | QZ | $407.38 | $407.38 | $407.38 |