| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $338.83 | $544.00 | $873.00 |
Aetna
| Professional | QZ | $415.55 | $620.12 | $1,126.05 |
Ambetter
| Professional | AA | $213.07 | $309.92 | $871.00 |
Ambetter
| Professional | QZ | $213.07 | $325.42 | $880.00 |