| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.77 | $148.91 | $693.00 | |
Medica
| Facility | $42.37 | $130.49 | $253.47 | |
Midlands
| Facility | $68.16 | $230.01 | $440.09 | |
Sanford Health Plan
| Professional | $52.24 | $160.54 | $270.39 | |
United
| Facility | $821.00 | $821.00 | $821.00 |