| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $2,091.00 | $2,091.00 | $2,091.00 | |
Oscar Health
| Professional | $10.00 | $2,792.70 | $4,153.20 | |
Wellcare
| Facility | $3,766.00 | $5,173.93 | $6,613.14 | |
Wellcare
| Professional | $10,732.74 | $10,732.74 | $10,732.74 |