| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $223.87 | $1,548.82 | $2,511.89 |
Aetna
| Professional | QZ | $309.03 | $309.03 | $309.03 |
Ambetter
| Professional | AA | $263.03 | $263.03 | $398.11 |
Ambetter
| Professional | QZ | $281.84 | $281.84 | $758.58 |