| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $96.72 | $156.29 | $389.28 | |
Oscar Health
| Professional | $105.30 | $121.10 | $179.50 | |
Wellcare
| Facility | $134.66 | $210.67 | $315.00 | |
Wellcare
| Professional | $603.00 | $603.00 | $603.00 |