| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $74.13 | $74.13 | $74.13 | |
Oscar Health
| Facility | $812.83 | $1,000.00 | $1,096.48 |
Professional Fees (Extension of 096X and 097X)-Emergency Room
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $74.13 | $74.13 | $74.13 | |
Oscar Health
| Facility | $812.83 | $1,000.00 | $1,096.48 |