| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $831.76 | $831.76 | $147,910.84 | |
Medica
| Professional | $2,089.30 | $2,089.30 | $2,089.30 | |
United
| Facility | $5,754.40 | $19,498.45 | $25,703.96 | |
United
| Professional | $295.12 | $363.08 | $691.83 |