| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,023.29 | $1,949.84 | $2,691.53 |
Aetna
| Professional | QZ | $177.83 | $177.83 | $177.83 |
Ambetter
| Professional | AA | $776.25 | $1,479.11 | $2,754.23 |
Ambetter
| Professional | QZ | $281.84 | $1,621.81 | $2,570.40 |