| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.94 | $121.63 | $121.63 | |
Medica
| Facility | $137.91 | $186.66 | $276.42 | |
Midlands
| Facility | $212.09 | $255.05 | $497.54 | |
Sanford Health Plan
| Professional | $119.28 | $174.11 | $233.53 | |
United
| Facility | $821.00 | $821.00 | $821.00 |