| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $549.54 | $1,202.26 | $3,019.95 |
Aetna
| Professional | QZ | $588.84 | $616.60 | $616.60 |
Ambetter
| Professional | AA | $194.98 | $194.98 | $194.98 |
Ambetter
| Professional | QZ | $194.98 | $199.53 | $512.86 |