| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $501.19 | $10,964.78 | $10,964.78 | |
Medica
| Professional | $851.14 | $851.14 | $851.14 | |
United
| Facility | $109.65 | $1,380.38 | $6,456.54 | |
United
| Professional | $218.78 | $263.03 | $426.58 |