| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $339.10 | $339.10 | $339.10 | |
Medica
| Facility | $420.45 | $573.08 | $921.46 | |
Midlands
| Facility | $632.00 | $797.82 | $1,049.09 | |
Sanford Health Plan
| Professional | $434.63 | $569.10 | $648.84 | |
United
| Facility | $821.00 | $821.00 | $821.00 |