| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $267.20 | $267.20 | $2,290.00 | |
Medica
| Facility | $260.30 | $418.51 | $678.53 | |
Midlands
| Facility | $486.50 | $628.19 | $821.77 | |
Sanford Health Plan
| Professional | $339.06 | $447.68 | $510.40 | |
Sanford Health Plan
| Professional | AS | $100.89 | $100.89 | $100.89 |
United
| Facility | $821.00 | $821.00 | $821.00 |