| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $426.58 | $933.25 | $1,949.84 |
Aetna
| Professional | QZ | $549.54 | $831.76 | $1,778.28 |
Ambetter
| Professional | AA | $134.90 | $204.17 | $524.81 |
Ambetter
| Professional | QZ | $141.25 | $218.78 | $562.34 |