| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $436.52 | $758.58 | $1,318.26 |
Aetna
| Professional | QZ | $309.03 | $537.03 | $1,000.00 |
Ambetter
| Professional | AA | $158.49 | $245.47 | $645.65 |
Ambetter
| Professional | QZ | $134.90 | $190.55 | $676.08 |