| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.22 | $62.22 | $2,290.00 | |
Medica
| Facility | $74.65 | $94.29 | $142.40 | |
Midlands
| Facility | $115.38 | $146.27 | $199.20 | |
Sanford Health Plan
| Professional | $77.45 | $108.37 | $123.56 | |
United
| Facility | $821.00 | $821.00 | $821.00 |