| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $370.51 | $370.51 | $2,290.00 | |
Medica
| Facility | $360.15 | $579.28 | $925.70 | |
Midlands
| Facility | $675.14 | $868.54 | $1,132.51 | |
Sanford Health Plan
| Professional | $470.10 | $619.60 | $706.41 | |
Sanford Health Plan
| Professional | 80 | $139.88 | $139.88 | $139.88 |
Sanford Health Plan
| Professional | AS | $139.88 | $139.88 | $139.88 |
United
| Facility | $821.00 | $821.00 | $821.00 |