| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.78 | $143.78 | $3,511.00 | |
Medica
| Facility | $180.65 | $242.99 | $421.14 | |
Midlands
| Facility | $240.00 | $380.01 | $497.43 | |
Sanford Health Plan
| Professional | $201.55 | $271.22 | $309.22 | |
United
| Facility | $821.00 | $821.00 | $821.00 |