| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,659.59 | $1,659.59 | $1,659.59 | |
Lucent Health
| Professional | $1,659.59 | $1,659.59 | $1,659.59 | |
Oscar Health
| Professional | $3.98 | $3.98 | $3.98 | |
United
| Professional | $229.09 | $295.12 | $602.56 |