| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $470.56 | $470.56 | $2,290.00 | |
Medica
| Facility | $569.77 | $779.80 | $1,286.20 | |
Midlands
| Facility | $739.55 | $1,089.41 | $1,556.95 | |
Sanford Health Plan
| Professional | $622.99 | $842.45 | $985.23 | |
Sanford Health Plan
| Professional | AS | $192.13 | $192.13 | $192.13 |
United
| Facility | $821.00 | $821.00 | $821.00 |