| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.26 | $117.26 | $2,290.00 | |
Medica
| Facility | $140.88 | $190.55 | $268.70 | |
Midlands
| Facility | $209.40 | $272.74 | $364.98 | |
Sanford Health Plan
| Professional | $147.38 | $198.02 | $225.77 | |
United
| Facility | $821.00 | $821.00 | $821.00 |