| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.29 | $164.29 | $164.29 | |
Medica
| Facility | $202.60 | $277.64 | $469.81 | |
Midlands
| Facility | $309.00 | $417.43 | $6,549.86 | |
Sanford Health Plan
| Professional | $205.86 | $268.95 | $306.63 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |