| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $391.50 | $483.08 | $1,082.30 | |
Oscar Health
| Professional | $369.40 | $493.80 | $574.90 | |
Wellcare
| Facility | $585.42 | $603.29 | $987.09 | |
Wellcare
| Professional | $1,658.00 | $1,658.00 | $1,658.00 |