| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $1,004.87 | $1,148.02 | $2,473.36 | |
Oscar Health
| Professional | $997.90 | $997.90 | $997.90 | |
Wellcare
| Facility | $55.00 | $1,828.17 | $2,812.02 | |
Wellcare
| Professional | $4,309.00 | $4,309.00 | $4,309.00 |