| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $7,789.00 | $7,789.00 | $7,789.00 |
Specialty Services-Other Specialty Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $7,789.00 | $7,789.00 | $7,789.00 |