| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.52 | $312.52 | $2,290.00 | |
Medica
| Facility | $375.16 | $450.18 | $687.58 | |
Midlands
| Facility | $225.63 | $577.83 | $803.06 | |
Sanford Health Plan
| Professional | $374.95 | $527.90 | $621.02 | |
United
| Facility | $821.00 | $821.00 | $821.00 |