| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $371.54 | $371.54 | $380.19 | |
Medcost
| Facility | $263.03 | $371.54 | $588.84 | |
Wellcare
| Facility | $56.23 | $2,041.74 | $2,041.74 | |
Wellcare
| Professional | $1,445.44 | $1,445.44 | $1,445.44 |