| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.04 | $144.04 | $144.04 | |
Medica
| Facility | $179.09 | $243.43 | $395.00 | |
Midlands
| Facility | $277.00 | $339.94 | $447.39 | |
Sanford Health Plan
| Professional | $185.96 | $242.85 | $276.87 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |