| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $55.00 | $55.00 | $4,664.43 | |
Lucent Health
| Professional | $13,636.00 | $13,636.00 | $13,636.00 | |
Oscar Health
| Professional | $2,219.69 | $2,219.69 | $2,219.69 | |
United
| Facility | $625.00 | $2,454.00 | $8,478.00 |