| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $1,258.93 | $4,073.80 | $4,073.80 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $1,258.93 | $4,073.80 | $4,073.80 |