| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $602.56 | $1,258.93 | $2,454.71 |
Aetna
| Professional | QZ | $630.96 | $870.96 | $933.25 |
Ambetter
| Professional | AA | $309.03 | $457.09 | $467.74 |
Ambetter
| Professional | QZ | $173.78 | $173.78 | $269.15 |