| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $2,398.83 | $3,801.89 | $13,803.84 | |
Medica
| Professional | $1,000.00 | $4,677.35 | $4,677.35 | |
United
| Facility | $1,000.00 | $1,000.00 | $1,995.26 | |
United
| Professional | $776.25 | $977.24 | $1,348.96 |