| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $1,775.00 | $1,775.00 | $1,775.00 | |
Oscar Health
| Professional | $10.00 | $2,384.40 | $3,652.60 | |
Wellcare
| Facility | $3,510.66 | $5,000.00 | $6,131.82 | |
Wellcare
| Professional | $9,115.20 | $9,115.20 | $9,115.20 |