| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $749.30 | $1,040.59 | $1,528.92 |
Aetna
| Professional | QZ | $876.30 | $907.50 | $2,463.80 |
Ambetter
| Professional | AA | $124.38 | $780.00 | $1,180.20 |
Ambetter
| Professional | QZ | $145.11 | $910.00 | $1,081.84 |