| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $1,787.04 | $2,042.92 | $4,563.74 | |
Oscar Health
| Professional | $1,837.40 | $1,837.40 | $1,837.40 | |
Wellcare
| Facility | $55.00 | $3,134.01 | $5,062.97 | |
Wellcare
| Professional | $8,345.00 | $8,345.00 | $8,345.00 |