| 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 | $1,380.38 | $2,454.71 | $2,951.21 | |
United
| Professional | $208.93 | $295.12 | $426.58 |