| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $15.82 | $26.11 | $39.72 | |
Oscar Health
| Professional | $28.20 | $28.20 | $28.20 | |
Wellcare
| Facility | $85.00 | $196.40 | $320.00 | |
Wellcare
| Professional | $291.00 | $291.00 | $320.00 |