| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.69 | $83.64 | $83.64 | |
Medica
| Facility | $78.40 | $123.57 | $225.29 | |
Midlands
| Facility | $134.63 | $166.04 | $248.19 | |
Sanford Health Plan
| Professional | $84.35 | $119.68 | $155.90 | |
United
| Facility | $821.00 | $821.00 | $821.00 |