| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.21 | $168.21 | $3,073.00 | |
Medica
| Facility | $221.62 | $284.27 | $464.15 | |
Midlands
| Facility | $264.63 | $398.17 | $953.00 | |
Sanford Health Plan
| Professional | $217.32 | $301.12 | $357.12 | |
United
| Facility | $821.00 | $821.00 | $821.00 |