| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,964.78 | $10,964.78 | $10,964.78 | |
Medica
| Professional | $1,000.00 | $1,000.00 | $1,000.00 | |
United
| Facility | $158.49 | $3,388.44 | $6,760.83 | |
United
| Professional | $338.84 | $338.84 | $338.84 |