| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $1,174.90 | $1,288.25 | $1,621.81 |
Pharmacy-Other Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $1,174.90 | $1,288.25 | $1,621.81 |