| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $259.29 | $259.29 | $2,290.00 | |
Medica
| Facility | $343.99 | $443.94 | $732.56 | |
Midlands
| Facility | $413.10 | $617.90 | $863.47 | |
Sanford Health Plan
| Professional | $347.53 | $481.72 | $549.22 | |
Sanford Health Plan
| Professional | 80 | $106.17 | $106.17 | $106.17 |
Sanford Health Plan
| Professional | AS | $106.17 | $106.17 | $106.17 |
United
| Facility | $821.00 | $821.00 | $821.00 |