| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.08 | $194.08 | $194.08 | |
Medica
| Facility | $241.28 | $328.00 | $531.79 | |
Midlands
| Facility | $374.00 | $458.45 | $603.79 | |
Sanford Health Plan
| Professional | $249.11 | $328.52 | $374.56 | |
United
| Facility | $821.00 | $821.00 | $821.00 |