| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $760.77 | $968.00 | $1,960.00 |
Aetna
| Professional | QZ | $549.79 | $857.23 | $907.90 |
Ambetter
| Professional | AA | $154.96 | $488.12 | $654.71 |
Ambetter
| Professional | QZ | $370.76 | $370.76 | $463.45 |