| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $891.15 | $891.15 | $891.15 | |
Lucent Health
| Facility | $55.00 | $55.00 | $4,576.84 | |
Lucent Health
| Professional | $4,363.00 | $4,363.00 | $4,363.00 | |
Oscar Health
| Professional | $869.10 | $869.10 | $869.10 |