| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $42.59 | $52.22 | $109.47 | |
Oscar Health
| Professional | $77.30 | $77.30 | $77.30 | |
Wellcare
| Facility | $107.94 | $192.42 | $194.52 | |
Wellcare
| Professional | $231.28 | $231.28 | $416.24 |