| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.33 | $164.63 | $164.63 | |
Medica
| Facility | $94.50 | $202.70 | $355.80 | |
Midlands
| Facility | $182.57 | $251.33 | $515.17 | |
Sanford Health Plan
| Professional | $120.48 | $208.52 | $313.75 | |
United
| Facility | $821.00 | $821.00 | $821.00 |