| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $896.11 | $896.11 | $4,338.00 | |
Medica
| Facility | $1,104.27 | $1,514.43 | $2,368.67 | |
Midlands
| Facility | $1,648.00 | $2,103.42 | $2,733.27 | |
Sanford Health Plan
| Professional | $1,118.35 | $1,514.39 | $1,726.58 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |