| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $4,168.69 | $6,165.95 | |
Medica
| Professional | $19,498.45 | $19,498.45 | $19,498.45 | |
United
| Facility | $1,122.02 | $1,548.82 | $6,456.54 | |
United
| Professional | $1,318.26 | $1,698.24 | $2,630.27 |