| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $501.19 | $501.19 | $501.19 | |
Medica
| Professional | $794.33 | $794.33 | $794.33 | |
United
| Facility | $165.96 | $407.38 | $2,951.21 | |
United
| Professional | $194.98 | $245.47 | $302.00 |