| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $283.27 | $385.77 | $555.10 | |
Oscar Health
| Professional | $6.00 | $6.00 | $723.30 | |
Wellcare
| Facility | $521.78 | $3,686.55 | $16,394.00 | |
Wellcare
| Professional | $3,635.00 | $3,635.00 | $3,635.00 |