| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.33 | $125.89 | $4,365.16 | |
Medica
| Facility | $123.03 | $181.97 | $269.15 | |
Midlands
| Professional | $204.17 | $208.93 | $269.15 | |
Sanford Health Plan
| Professional | $123.03 | $186.21 | $251.19 | |
United
| Facility | $812.83 | $812.83 | $812.83 |