| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $3,023.49 | $3,532.08 | $6,225.32 | |
Oscar Health
| Professional | $2,776.80 | $2,776.80 | $2,776.80 | |
Wellcare
| Facility | $55.00 | $5,571.61 | $8,905.14 | |
Wellcare
| Professional | $17,046.00 | $17,046.00 | $17,046.00 |