| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $363.08 | $954.99 | $954.99 | |
Medica
| Professional | $165.96 | $251.19 | $1,479.11 | |
United
| Facility | $52.48 | $147.91 | $199.53 | |
United
| Professional | $173.78 | $213.80 | $323.59 |