| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $531.20 | $531.20 | $531.20 |
Ambetter
| Professional | QZ | $96.85 | $96.85 | $133.65 |
Anes Perq Img Dstrj Px Nulyt Agt Spi/Sp Lmbr/Sac
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $531.20 | $531.20 | $531.20 |
Ambetter
| Professional | QZ | $96.85 | $96.85 | $133.65 |