| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.34 | $212.06 | $212.06 | |
Medica
| Facility | $168.38 | $309.22 | $557.40 | |
Midlands
| Facility | $307.61 | $473.35 | $562.99 | |
Sanford Health Plan
| Professional | $209.51 | $319.76 | $428.89 | |
United
| Facility | $821.00 | $821.00 | $821.00 |