| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $1,738.20 | $2,090.05 | $2,580.79 | |
Oscar Health
| Professional | $1,882.60 | $1,882.60 | $1,882.60 | |
Wellcare
| Facility | $55.00 | $3,216.19 | $5,204.25 | |
Wellcare
| Professional | $8,781.00 | $8,781.00 | $8,781.00 |