| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $565.77 | $1,260.00 | $2,240.00 |
Aetna
| Professional | QZ | $636.29 | $835.66 | $1,790.70 |
Ambetter
| Professional | AA | $361.98 | $570.00 | $876.39 |
Ambetter
| Professional | QZ | $115.86 | $160.88 | $1,067.80 |