| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.65 | $156.65 | $156.65 | |
Medica
| Facility | $153.94 | $264.74 | $426.69 | |
Midlands
| Facility | $296.00 | $369.03 | $483.87 | |
Sanford Health Plan
| Professional | $199.37 | $264.41 | $301.45 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |