| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.95 | $137.94 | $137.94 | |
Medica
| Facility | $98.20 | $191.80 | $379.95 | |
Midlands
| Facility | $184.41 | $261.00 | $378.35 | |
Sanford Health Plan
| Professional | $125.38 | $200.15 | $268.45 | |
United
| Facility | $821.00 | $821.00 | $821.00 |