| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Oscar Health
| Facility | $364.32 | $4,219.74 | $8,590.20 | |
Wellmark
| Facility | $18,170.00 | $28,440.00 | $40,290.00 |
MRA - Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $150.00 | $150.00 | $150.00 | |
Oscar Health
| Facility | $364.32 | $4,219.74 | $8,590.20 | |
Wellmark
| Facility | $18,170.00 | $28,440.00 | $40,290.00 |