| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $97.72 | $97.72 | $97.72 | |
Oscar Health
| Facility | $549.54 | $1,202.26 | $3,388.44 | |
Wellmark
| Facility | $18,197.01 | $28,183.83 | $40,738.03 |