| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $164.00 | $164.00 | $164.00 | |
Oscar Health
| Professional | $5.00 | $192.30 | $348.60 | |
Wellcare
| Facility | $148.09 | $214.60 | $16,394.00 | |
Wellcare
| Professional | $638.00 | $687.43 | $687.43 |