| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $917.96 | $917.96 | $917.96 | |
Medica
| Facility | $1,133.16 | $1,551.35 | $2,463.42 | |
Midlands
| Facility | $1,717.00 | $2,150.38 | $2,820.87 | |
Sanford Health Plan
| Professional | $1,160.32 | $1,536.52 | $1,751.81 | |
United
| Facility | $5,357.00 | $5,357.00 | $5,357.00 |