| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $109.02 | $109.02 | $274.39 |
Aetna
| Professional | QZ | $89.01 | $99.13 | $131.50 |
Ambetter
| Professional | AA | $120.30 | $156.08 | $1,120.00 |
Ambetter
| Professional | QZ | $117.06 | $136.57 | $409.71 |