| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $501.19 | $501.19 | $501.19 | |
Oscar Health
| Professional | $323.59 | $389.05 | $851.14 | |
Wellcare
| Facility | $3,630.78 | $3,630.78 | $3,630.78 | |
Wellcare
| Professional | $1,819.70 | $1,819.70 | $1,819.70 |