| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.40 | $77.40 | $2,290.00 | |
Medica
| Facility | $90.12 | $106.50 | $203.12 | |
Midlands
| Facility | $117.68 | $186.42 | $231.53 | |
Sanford Health Plan
| Professional | $92.11 | $124.16 | $143.61 | |
United
| Facility | $821.00 | $821.00 | $821.00 |