| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $3,640.50 | $7,634.97 | $7,634.97 | |
Lucent Health
| Professional | $14,768.00 | $16,929.27 | $16,929.27 | |
Oscar Health
| Professional | $3,245.40 | $3,245.40 | $3,245.40 |