| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $606.79 | $980.00 | $1,540.00 |
Aetna
| Professional | QZ | $545.40 | $545.40 | $1,313.18 |
Ambetter
| Professional | AA | $180.99 | $480.00 | $1,067.80 |
Ambetter
| Professional | QZ | $140.77 | $140.77 | $140.77 |