| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $930.93 | $930.93 | $4,338.00 | |
Medica
| Facility | $1,146.99 | $1,573.27 | $2,486.42 | |
Midlands
| Facility | $1,731.00 | $2,169.39 | $2,857.37 | |
Sanford Health Plan
| Professional | $1,166.80 | $1,546.73 | $1,763.45 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |