| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.79 | $139.36 | $139.36 | |
Medica
| Facility | $160.27 | $223.14 | $383.59 | |
Midlands
| Facility | $276.00 | $329.65 | $427.58 | |
Sanford Health Plan
| Professional | $160.83 | $247.75 | $298.87 | |
United
| Facility | $821.00 | $821.00 | $821.00 |