| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $557.15 | $4,676.00 | $14,977.84 | |
Medica
| Professional | $612.44 | $892.97 | $4,655.12 | |
United
| Facility | $3,685.16 | $3,685.16 | $3,685.16 | |
United
| Professional | $611.99 | $899.99 | $1,379.64 |