| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $469.37 | $549.62 | $1,212.98 | |
Oscar Health
| Professional | $509.60 | $509.60 | $509.60 | |
Wellcare
| Facility | $55.00 | $821.75 | $4,995.10 | |
Wellcare
| Professional | $1,731.00 | $4,155.10 | $4,155.10 |