| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.15 | $144.15 | $2,290.00 | |
Medica
| Facility | $169.60 | $266.37 | $759.76 | |
Midlands
| Facility | $334.45 | $369.78 | $502.00 | |
Sanford Health Plan
| Professional | $191.16 | $258.13 | $480.99 | |
United
| Facility | $821.00 | $821.00 | $821.00 |