| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.95 | $54.95 | $3,235.94 | |
Medica
| Professional | $14,454.40 | $14,454.40 | $14,454.40 | |
United
| Facility | $851.14 | $1,122.02 | $2,951.21 | |
United
| Professional | $1,380.38 | $1,778.28 | $2,089.30 |