| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.01 | $181.63 | $181.63 | |
Medica
| Facility | $148.91 | $256.14 | $477.25 | |
Midlands
| Facility | $265.86 | $345.19 | $496.32 | |
Sanford Health Plan
| Professional | $182.02 | $266.23 | $357.09 | |
United
| Facility | $821.00 | $821.00 | $821.00 |