| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $75,857.76 | $75,857.76 | $75,857.76 | |
Lucent Health
| Professional | $1,023.29 | $1,023.29 | $1,023.29 | |
Oscar Health
| Professional | $7.08 | $7.08 | $7.08 | |
United
| Professional | $251.19 | $309.03 | $436.52 |