| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $144.54 | $1,905.46 | $2,818.38 |
Aetna
| Professional | QZ | $128.82 | $812.83 | $1,148.15 |
Ambetter
| Professional | AA | $251.19 | $251.19 | $251.19 |
Ambetter
| Professional | QZ | $162.18 | $218.78 | $1,548.82 |