| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $213.80 | $213.80 | $213.80 | |
Oscar Health
| Facility | $190.55 | $257.04 | $257.04 |
Professional Fees (Extension of 096X and 097X)-Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $213.80 | $213.80 | $213.80 | |
Oscar Health
| Facility | $190.55 | $257.04 | $257.04 |