| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $1,754.00 | $1,754.00 | $1,754.00 | |
Oscar Health
| Professional | $10.00 | $2,145.50 | $3,335.40 | |
Wellcare
| Facility | $3,131.80 | $5,000.00 | $5,201.28 | |
Wellcare
| Professional | $11,171.88 | $11,171.88 | $11,171.88 |