| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $466.69 | $756.60 | $1,132.45 |
Aetna
| Professional | QZ | $549.79 | $549.79 | $645.82 |
Ambetter
| Professional | AA | $154.96 | $654.71 | $940.04 |
Ambetter
| Professional | QZ | $515.24 | $677.03 | $1,275.00 |