| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $117.49 | $117.49 | $117.49 | |
Oscar Health
| Professional | $91.20 | $138.04 | $229.09 | |
Wellcare
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
Wellcare
| Professional | $398.11 | $426.58 | $426.58 |