| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.77 | $77.77 | $2,290.00 | |
Medica
| Facility | $90.12 | $131.43 | $203.12 | |
Midlands
| Facility | $117.48 | $186.42 | $234.63 | |
Sanford Health Plan
| Professional | $96.01 | $124.16 | $144.26 | |
United
| Facility | $821.00 | $821.00 | $821.00 |