| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $16.22 | $26.92 | $42.66 | |
Oscar Health
| Professional | $21.88 | $21.88 | $21.88 | |
Wellcare
| Facility | $302.00 | $302.00 | $323.59 | |
Wellcare
| Professional | $288.40 | $288.40 | $323.59 |