| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $257.04 | $257.04 | $501.19 | |
Medica
| Professional | $794.33 | $794.33 | $794.33 | |
United
| Facility | $389.05 | $389.05 | $2,570.40 | |
United
| Professional | $151.36 | $213.80 | $302.00 |