| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.13 | $222.72 | $222.72 | |
Medica
| Facility | $192.41 | $328.30 | $598.34 | |
Midlands
| Facility | $186.85 | $448.43 | $641.12 | |
Sanford Health Plan
| Professional | $232.32 | $342.93 | $445.07 | |
United
| Facility | $821.00 | $821.00 | $821.00 |