| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.79 | $138.04 | $4,365.16 | |
Medica
| Facility | $89.13 | $169.82 | $354.81 | |
Midlands
| Professional | $165.96 | $177.83 | $331.13 | |
Sanford Health Plan
| Professional | $125.89 | $199.53 | $269.15 | |
United
| Facility | $812.83 | $812.83 | $812.83 |