| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $2,924.42 | $3,425.58 | $8,459.92 | |
Capital Blue Cross
| Professional | $3,425.58 | $3,425.58 | $3,425.58 | |
Cigna
| Professional | $3,520.18 | $3,694.44 | $4,426.35 | |
Oscar Health
| Professional | $27.40 | $6,328.40 | $7,696.80 | |
Priority Health
| Professional | $3,520.18 | $3,694.44 | $4,426.35 |