| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.84 | $1,025.45 | $18,050.00 | |
Medica
| Facility | $1,346.33 | $1,732.60 | $2,706.63 | |
Midlands
| Facility | $1,555.65 | $2,533.91 | $8,250.46 | |
Sanford Health Plan
| Professional | $1,276.67 | $1,735.38 | $2,035.79 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |