| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.80 | $141.40 | $141.40 | |
Aetna
| Professional | $123.80 | $154.34 | $224.00 | |
Martin's Point
| Facility | $141.40 | $141.40 | $141.40 | |
Martin's Point
| Professional | $123.80 | $154.34 | $224.00 | |
Oscar Health
| Professional | $325.00 | $325.00 | $325.00 |