| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $204.17 | $204.17 | $204.17 |
Aetna
| Professional | QZ | $117.49 | $117.49 | $128.82 |
Ambetter
| Professional | QZ | $162.18 | $218.78 | $524.81 |
BCBS
| Professional | AA | $186.21 | $302.00 | $407.38 |
BCBS
| Professional | QZ | $120.23 | $208.93 | $323.59 |