| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $887.34 | $887.34 | $4,338.00 | |
Medica
| Facility | $1,067.43 | $1,467.34 | $2,211.44 | |
Midlands
| Facility | $1,281.32 | $1,941.79 | $2,767.69 | |
Sanford Health Plan
| Professional | $1,011.81 | $1,439.95 | $1,722.69 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |