| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $537.03 | $912.01 | $1,621.81 |
Aetna
| Professional | QZ | $316.23 | $691.83 | $1,288.25 |
Ambetter
| Professional | AA | $229.09 | $380.19 | $645.65 |
Ambetter
| Professional | QZ | $154.88 | $295.12 | $660.69 |