| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.07 | $135.07 | $2,290.00 | |
Medica
| Facility | $129.44 | $209.56 | $339.76 | |
Midlands
| Facility | $209.32 | $312.91 | $406.70 | |
Sanford Health Plan
| Professional | $178.78 | $222.99 | $254.23 | |
United
| Facility | $821.00 | $821.00 | $821.00 |