| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Partners
| Professional | $42.66 | $42.66 | $42.66 | |
Medica
| Facility | $75.86 | $75.86 | $75.86 | |
Medica
| Professional | $295.12 | $295.12 | $295.12 | |
United
| Professional | $40.74 | $52.48 | $112.20 |