| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $1,596.00 | $1,596.00 | $1,596.00 | |
Oscar Health
| Professional | $10.00 | $2,052.60 | $4,056.10 | |
Wellcare
| Facility | $3,009.57 | $5,000.00 | $5,219.25 | |
Wellcare
| Professional | $7,846.44 | $7,846.44 | $7,846.44 |