| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $864.54 | $864.54 | $4,338.00 | |
Medica
| Facility | $1,064.58 | $1,461.07 | $2,302.19 | |
Midlands
| Facility | $1,568.00 | $2,034.20 | $2,645.67 | |
Sanford Health Plan
| Professional | $1,087.22 | $1,449.14 | $1,652.18 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |