| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $204.42 | $304.62 | $409.97 | |
Oscar Health
| Facility | $129.50 | $129.50 | $129.50 | |
Oscar Health
| Professional | $129.50 | $146.60 | $323.39 | |
Priority Health
| Professional | $204.42 | $304.62 | $409.97 |