| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $575.44 | $977.24 | $1,819.70 |
Aetna
| Professional | QZ | $724.44 | $724.44 | $724.44 |
Ambetter
| Professional | AA | $194.98 | $398.11 | $1,380.38 |
Ambetter
| Professional | QZ | $194.98 | $223.87 | $1,047.13 |