| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $3,548.13 | $4,365.16 | |
Medica
| Facility | $169.82 | $218.78 | $371.54 | |
Midlands
| Professional | $288.40 | $309.03 | $309.03 | |
Sanford Health Plan
| Professional | $169.82 | $223.87 | $275.42 | |
Sanford Health Plan
| Professional | AS | $53.70 | $53.70 | $53.70 |
United
| Facility | $812.83 | $812.83 | $812.83 |