| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
Anthem BCBS
| Professional | $489.78 | $489.78 | $489.78 |
SurFactor or NuDyn, per 0.5 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
Anthem BCBS
| Professional | $489.78 | $489.78 | $489.78 |