| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $10,939.34 | $10,939.34 | $21,412.50 |
Special Charges-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $10,939.34 | $10,939.34 | $21,412.50 |