| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $165.38 | $412.77 | $1,114.21 | |
Oscar Health
| Professional | $522.29 | $522.29 | $522.29 | |
Wellcare
| Facility | $298.32 | $553.44 | $1,600.36 | |
Wellcare
| Professional | $2,930.00 | $2,930.00 | $2,930.00 |