| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $611.02 | $781.06 | $1,123.49 | |
Oscar Health
| Professional | $10.00 | $10.00 | $1,373.30 | |
Wellcare
| Facility | $55.00 | $1,383.46 | $3,362.83 | |
Wellcare
| Professional | $9,087.00 | $9,087.00 | $9,087.00 |