| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.16 | $127.16 | $3,511.00 | |
Medica
| Facility | $169.31 | $228.73 | $365.90 | |
Midlands
| Facility | $208.15 | $311.56 | $416.09 | |
Sanford Health Plan
| Professional | $174.19 | $233.09 | $273.44 | |
Sanford Health Plan
| Professional | AS | $52.76 | $52.76 | $52.76 |
United
| Facility | $821.00 | $821.00 | $821.00 |