| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $131.83 | $794.33 | $794.33 | |
Medica
| Professional | $223.87 | $223.87 | $223.87 | |
United
| Facility | $1,000.00 | $1,000.00 | $1,995.26 | |
United
| Professional | $14.45 | $56.23 | $77.62 |