| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $457.09 | $457.09 | $457.09 | |
Medica
| Professional | $776.25 | $776.25 | $776.25 | |
United
| Facility | $41.69 | $1,047.13 | $2,951.21 | |
United
| Professional | $33.11 | $43.65 | $48.98 |