| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.59 | $183.38 | $183.38 | |
Medica
| Facility | $173.60 | $249.43 | $821.00 | |
Midlands
| Facility | $318.51 | $414.13 | $584.01 | |
Sanford Health Plan
| Professional | $193.50 | $289.16 | $375.85 | |
United
| Facility | $821.00 | $821.00 | $821.00 |