| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.22 | $151.81 | $151.81 | |
Medica
| Facility | $48.81 | $152.63 | $262.80 | |
Midlands
| Facility | $89.27 | $251.47 | $460.93 | |
Sanford Health Plan
| Professional | $57.81 | $179.63 | $267.82 | |
United
| Facility | $821.00 | $821.00 | $821.00 |