| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.55 | $275.81 | $275.81 | |
Medica
| Facility | $89.02 | $237.84 | $626.67 | |
Midlands
| Facility | $184.08 | $509.00 | $825.92 | |
Sanford Health Plan
| Professional | $123.18 | $354.01 | $474.82 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |