| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $539.17 | $539.17 | $2,290.00 | |
Medica
| Facility | $664.61 | $884.56 | $1,374.99 | |
Midlands
| Facility | $794.61 | $1,332.64 | $3,711.03 | |
Sanford Health Plan
| Professional | $608.15 | $897.83 | $1,075.15 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |