| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $954.99 | $1,548.82 | $2,398.83 |
Aetna
| Professional | QZ | $602.56 | $1,380.38 | $1,380.38 |
Ambetter
| Professional | AA | $346.74 | $575.44 | $1,698.24 |
Ambetter
| Professional | QZ | $213.80 | $245.47 | $354.81 |