| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $341.32 | $559.32 | $1,131.25 |
Aetna
| Professional | QZ | $576.03 | $591.88 | $591.88 |
Ambetter
| Professional | AA | $101.25 | $162.71 | $325.00 |
Ambetter
| Professional | QZ | $100.30 | $154.46 | $280.83 |