| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $907.20 | $1,540.00 | $2,240.00 |
Aetna
| Professional | QZ | $952.25 | $952.25 | $952.25 |
Ambetter
| Professional | AA | $350.00 | $923.00 | $996.00 |
Ambetter
| Professional | QZ | $193.90 | $193.90 | $193.90 |