| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $2,055.00 | $2,055.00 | $2,055.00 | |
Oscar Health
| Professional | $13.00 | $2,194.19 | $4,235.20 | |
Wellcare
| Facility | $3,371.00 | $5,242.08 | $5,305.62 | |
Wellcare
| Professional | $11,402.46 | $11,402.46 | $11,402.46 |