| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $392.70 | $392.70 | $392.70 |
Ambetter
| Professional | QX | $155.59 | $155.59 | $155.59 |
Ambetter
| Professional | QZ | $97.55 | $170.71 | $191.20 |
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 | $392.70 | $392.70 | $392.70 |
Ambetter
| Professional | QX | $155.59 | $155.59 | $155.59 |
Ambetter
| Professional | QZ | $97.55 | $170.71 | $191.20 |