| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,174.90 | $1,621.81 | $3,162.28 |
Aetna
| Professional | QZ | $1,548.82 | $1,548.82 | $1,548.82 |
Ambetter
| Professional | AA | $234.42 | $234.42 | $316.23 |
Ambetter
| Professional | QZ | $295.12 | $323.59 | $331.13 |