| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,148.15 | $1,148.15 | $1,148.15 | |
Medica
| Professional | $4,365.16 | $4,365.16 | $4,365.16 | |
United
| Facility | $741.31 | $1,778.28 | $3,162.28 | |
United
| Professional | $707.95 | $933.25 | $1,258.93 |