| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $239.34 | $325.79 | $634.14 |
Aetna
| Professional | QZ | $1,175.28 | $1,175.28 | $1,175.28 |
Ambetter
| Professional | AA | $318.95 | $354.06 | $659.17 |
Ambetter
| Professional | QZ | $178.02 | $318.95 | $382.74 |
BCBS
| Professional | AA | $210.00 | $351.00 | $511.08 |
BCBS
| Professional | QZ | $168.00 | $240.00 | $363.00 |