| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $54.95 | $4,677.35 | |
Medica
| Professional | $13,489.63 | $13,489.63 | $13,489.63 | |
United
| Facility | $1,000.00 | $1,000.00 | $1,995.26 | |
United
| Professional | $1,047.13 | $1,318.26 | $1,737.80 |