| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.77 | $119.77 | $2,290.00 | |
Medica
| Facility | $144.10 | $179.77 | $274.85 | |
Midlands
| Facility | $222.50 | $278.69 | $381.69 | |
Sanford Health Plan
| Professional | $147.38 | $211.07 | $240.65 | |
United
| Facility | $821.00 | $821.00 | $821.00 |