| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,260.50 | $2,260.50 | $2,260.50 |
Ambetter
| Professional | AA | $461.38 | $461.38 | $461.38 |
Ambetter
| Professional | QZ | $830.25 | $830.25 | $830.25 |
BCBS
| Professional | QZ | $295.83 | $578.00 | $768.40 |
Health Alliance Plan
| Professional | AA | $2,260.50 | $2,260.50 | $2,260.50 |