| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.58 | $78.58 | $78.58 | |
Medica
| Facility | $76.63 | $132.80 | $214.25 | |
Midlands
| Facility | $148.00 | $185.36 | $242.97 | |
Sanford Health Plan
| Professional | $101.20 | $131.63 | $150.08 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |