| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $326.04 | $840.00 | $1,680.00 |
Aetna
| Professional | QZ | $326.04 | $412.50 | $660.00 |
Ambetter
| Professional | AA | $138.53 | $146.33 | $644.00 |
Ambetter
| Professional | QZ | $98.95 | $178.11 | $552.00 |