| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $205.36 | $205.36 | $205.36 | |
Medica
| Facility | $240.28 | $283.97 | $567.20 | |
Midlands
| Facility | $323.51 | $500.53 | $651.78 | |
Sanford Health Plan
| Professional | $268.56 | $356.36 | $397.84 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |