| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $867.41 | $867.41 | $867.41 | |
Medica
| Facility | $1,102.51 | $1,432.60 | $2,326.71 | |
Midlands
| Facility | $1,337.12 | $2,132.88 | $6,855.77 | |
Sanford Health Plan
| Professional | $1,056.00 | $1,474.29 | $1,687.12 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |