| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.67 | $275.89 | $275.89 | |
Medica
| Facility | $124.96 | $237.44 | $627.98 | |
Midlands
| Facility | $205.77 | $560.41 | $887.36 | |
Sanford Health Plan
| Professional | $140.02 | $333.47 | $498.11 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |