| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $803.99 | $803.99 | $803.99 | |
Lucent Health
| Facility | $5,640.95 | $26,542.00 | $26,542.00 | |
Lucent Health
| Professional | $6,228.00 | $6,228.00 | $6,228.00 | |
Oscar Health
| Professional | $814.30 | $814.30 | $814.30 |