| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,401.31 | $1,425.26 | $2,466.19 |
Aetna
| Professional | QZ | $558.00 | $558.00 | $558.00 |
Ambetter
| Professional | AA | $592.00 | $592.00 | $592.00 |
Wellcare
| Facility | QK | $37.00 | $37.00 | $39.50 |
Wellcare
| Facility | QX | $37.00 | $37.00 | $39.50 |
Wellcare
| Facility | QY | $37.00 | $37.00 | $39.50 |