| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $741.31 | $2,137.96 | $3,019.95 |
Aetna
| Professional | QZ | $512.86 | $831.76 | $912.01 |
Ambetter
| Professional | AA | $239.88 | $239.88 | $263.03 |
Ambetter
| Professional | QZ | $123.03 | $154.88 | $269.15 |
Aultcare
| Professional | AA | $512.86 | $512.86 | $602.56 |
Aultcare
| Professional | QZ | $446.68 | $501.19 | $933.25 |