| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,113.55 | $2,113.55 | $4,422.00 | |
Lucent Health
| Facility | $11,500.00 | $26,542.00 | $26,542.00 | |
Lucent Health
| Professional | $8,540.95 | $9,782.46 | $9,782.46 | |
Oscar Health
| Professional | $2,333.60 | $2,333.60 | $2,333.60 |