| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $587.09 | $753.89 | $1,081.45 | |
Oscar Health
| Professional | $15.00 | $15.00 | $1,377.10 | |
Wellcare
| Facility | $55.00 | $1,329.04 | $1,878.92 | |
Wellcare
| Professional | $6,244.00 | $6,244.00 | $6,244.00 |