| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.06 | $198.71 | $198.71 | |
Medica
| Facility | $154.34 | $290.58 | $520.86 | |
Midlands
| Facility | $280.39 | $442.83 | $526.08 | |
Sanford Health Plan
| Professional | $191.92 | $297.58 | $399.14 | |
United
| Facility | $821.00 | $821.00 | $821.00 |