| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $5,128.61 | $5,128.61 | $11,748.98 | |
Medica
| Professional | $11,748.98 | $11,748.98 | $11,748.98 | |
United
| Facility | $2,951.21 | $4,265.80 | $4,265.80 | |
United
| Professional | $1,230.27 | $1,230.27 | $1,737.80 |