| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $398.11 | $660.69 | $1,122.02 |
Aetna
| Professional | QZ | $281.84 | $489.78 | $776.25 |
Ambetter
| Professional | AA | $144.54 | $177.83 | $407.38 |
Ambetter
| Professional | QZ | $134.90 | $162.18 | $354.81 |