| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $851.14 | $1,737.80 | $2,691.53 |
Aetna
| Professional | QZ | $588.84 | $933.25 | $1,479.11 |
Ambetter
| Professional | AA | $138.04 | $354.81 | $691.83 |
Ambetter
| Professional | QZ | $144.54 | $416.87 | $478.63 |
Aultcare
| Professional | QZ | $660.69 | $1,288.25 | $1,949.84 |