| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Partners
| Professional | $54.95 | $54.95 | $54.95 | |
Medica
| Facility | $87.10 | $87.10 | $87.10 | |
Medica
| Professional | $338.84 | $338.84 | $338.84 | |
United
| Professional | $46.77 | $60.26 | $128.82 |