| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $94.71 | $551.48 | $1,098.22 | |
Oscar Health
| Professional | $5.00 | $140.69 | $1,168.80 | |
Wellcare
| Facility | $185.43 | $4,085.55 | $12,000.00 | |
Wellcare
| Professional | $4,284.00 | $4,284.00 | $4,284.00 |