| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $94.42 | $194.16 | $279.85 | |
Oscar Health
| Professional | $3.00 | $3.00 | $407.40 | |
Wellcare
| Facility | $55.00 | $198.39 | $1,300.00 | |
Wellcare
| Professional | $1,367.00 | $1,367.00 | $1,367.00 |