| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.19 | $317.52 | $769.08 | |
Medica
| Facility | $158.72 | $217.82 | $347.33 | |
Midlands
| Facility | $190.00 | $299.14 | $432.79 | |
Sanford Health Plan
| Professional | $154.22 | $232.52 | $273.64 | |
United
| Facility | $821.00 | $821.00 | $821.00 |