| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $478.63 | $645.65 | $2,187.76 |
Aetna
| Professional | QZ | $213.80 | $954.99 | $1,288.25 |
Ambetter
| Professional | AA | $562.34 | $562.34 | $562.34 |
Ambetter
| Professional | QZ | $173.78 | $173.78 | $776.25 |