| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $335.72 | $335.72 | $2,290.00 | |
Medica
| Facility | $446.19 | $589.21 | $945.66 | |
Midlands
| Facility | $537.26 | $804.83 | $1,107.50 | |
Sanford Health Plan
| Professional | $445.09 | $613.36 | $699.30 | |
Sanford Health Plan
| Professional | 80 | $136.15 | $136.15 | $136.15 |
Sanford Health Plan
| Professional | AS | $136.15 | $136.15 | $136.15 |
United
| Facility | $821.00 | $821.00 | $821.00 |