| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna
| Professional | QZ | $123.03 | $398.11 | $549.54 |
Ambetter
| Professional | AA | $154.88 | $154.88 | $154.88 |
Ambetter
| Professional | QZ | $100.00 | $100.00 | $123.03 |