| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $354.81 | $602.56 | $1,122.02 |
Aetna
| Professional | QZ | $316.23 | $524.81 | $891.25 |
Ambetter
| Professional | AA | $162.18 | $389.05 | $776.25 |
Ambetter
| Professional | QZ | $134.90 | $162.18 | $204.17 |