| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $102.54 | $400.94 | $524.32 | |
Oscar Health
| Professional | $361.30 | $375.80 | $664.50 | |
Wellcare
| Facility | $172.44 | $189.59 | $12,000.00 | |
Wellcare
| Professional | $1,368.00 | $1,368.00 | $1,368.00 |