| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,120.10 | $5,120.10 | $5,120.10 | |
Anthem BCBS
| Professional | $487.50 | $487.50 | $487.50 | |
Medica
| Facility | $100.00 | $100.00 | $7,680.17 |
SurFactor or NuDyn, per 0.5 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,120.10 | $5,120.10 | $5,120.10 | |
Anthem BCBS
| Professional | $487.50 | $487.50 | $487.50 | |
Medica
| Facility | $100.00 | $100.00 | $7,680.17 |