| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $691.83 | $1,174.90 | $1,621.81 |
Aetna
| Professional | QZ | $954.99 | $954.99 | $954.99 |
Ambetter
| Professional | AA | $354.81 | $354.81 | $645.65 |
Ambetter
| Professional | QZ | $239.88 | $354.81 | $758.58 |