| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $891.25 | $891.25 | $891.25 | |
Medica
| Professional | $1,548.82 | $1,548.82 | $1,548.82 | |
United
| Facility | $316.23 | $1,047.13 | $2,951.21 | |
United
| Professional | $363.08 | $363.08 | $363.08 |