| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.00 | $65.00 | $65.00 | |
Ambetter
| Facility | $170.32 | $170.32 | $170.32 | |
Anthem BCBS
| Facility | $687.24 | $1,198.80 | $1,905.03 |
Specialty Services-Other Specialty Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.00 | $65.00 | $65.00 | |
Ambetter
| Facility | $170.32 | $170.32 | $170.32 | |
Anthem BCBS
| Facility | $687.24 | $1,198.80 | $1,905.03 |