| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.69 | $129.69 | $2,290.00 | |
Medica
| Facility | $172.20 | $228.07 | $366.46 | |
Midlands
| Facility | $207.52 | $311.49 | $435.89 | |
Sanford Health Plan
| Professional | $174.19 | $240.20 | $276.87 | |
United
| Facility | $821.00 | $821.00 | $821.00 |