| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $660.69 | $1,513.56 | $2,238.72 |
Aetna
| Professional | QZ | $1,380.38 | $1,380.38 | $1,380.38 |
Ambetter
| Professional | AA | $851.14 | $851.14 | $851.14 |
Ambetter
| Professional | QZ | $218.78 | $218.78 | $223.87 |