| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $527.00 | $527.00 | $527.00 | |
Oscar Health
| Professional | $3.00 | $571.10 | $1,168.20 | |
Wellcare
| Facility | $1,014.44 | $8,138.20 | $26,542.00 | |
Wellcare
| Professional | $1,930.78 | $2,625.27 | $2,625.27 |