| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.03 | $88.00 | $88.00 | |
Medica
| Facility | $71.64 | $122.85 | $216.31 | |
Midlands
| Facility | $126.52 | $165.28 | $259.67 | |
Sanford Health Plan
| Professional | $84.72 | $122.99 | $164.96 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |