| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $155.69 | $180.78 | $246.26 | |
Oscar Health
| Professional | $165.70 | $165.70 | $165.70 | |
Wellcare
| Facility | $831.60 | $831.60 | $1,524.13 | |
Wellcare
| Professional | $5,807.00 | $5,807.00 | $5,807.00 |