| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $865.79 | $865.79 | $3,511.00 | |
Medica
| Facility | $1,044.33 | $1,342.81 | $2,290.34 | |
Midlands
| Facility | $1,316.25 | $2,143.50 | $10,682.84 | |
Sanford Health Plan
| Professional | $1,028.75 | $1,469.33 | $1,728.52 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |