| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.21 | $1,433.51 | $8,422.60 | |
Aetna
| Facility | 52 | $124.11 | $124.11 | $716.76 |
Medica
| Facility | $291.67 | $1,156.01 | $2,714.00 | |
Midlands
| Facility | $536.24 | $2,305.94 | $3,880.85 | |
Sanford Health Plan
| Professional | $346.29 | $1,270.08 | $2,394.82 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |