| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.05 | $1,197.00 | $1,261.26 | |
Aetna
| Facility | 52 | $48.53 | $48.53 | $598.50 |
Medica
| Facility | $126.07 | $976.27 | $2,672.65 | |
Midlands
| Facility | $235.97 | $2,099.10 | $3,423.56 | |
Sanford Health Plan
| Professional | $155.07 | $1,635.60 | $2,328.34 | |
United
| Facility | $821.00 | $821.00 | $821.00 |