| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $831.76 | $831.76 | $831.76 | |
Medica
| Professional | $2,089.30 | $2,089.30 | $2,089.30 | |
United
| Facility | $316.23 | $5,011.87 | $21,379.62 | |
United
| Professional | $354.81 | $398.11 | $501.19 |