| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.15 | $231.90 | $231.90 | |
Medica
| Facility | $146.68 | $280.00 | $534.23 | |
Midlands
| Facility | $273.80 | $354.00 | $523.91 | |
Sanford Health Plan
| Professional | $172.48 | $295.36 | $415.96 | |
United
| Facility | $821.00 | $821.00 | $821.00 |