| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,759.00 | $4,759.00 | $4,759.00 | |
Anthem BCBS
| Facility | $1,490.00 | $3,005.00 | $5,735.00 |
Specialty Services-Other Specialty Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,759.00 | $4,759.00 | $4,759.00 | |
Anthem BCBS
| Facility | $1,490.00 | $3,005.00 | $5,735.00 |