| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.88 | $261.43 | $6,634.46 | |
Aetna
| Professional | 50 | $163.56 | $163.56 | $461.70 |
Medica
| Facility | $160.19 | $304.58 | $550.27 | |
Medica
| Facility | 50 | $10,064.00 | $10,064.00 | $10,064.00 |
Midlands
| Facility | $260.81 | $435.96 | $735.18 | |
Sanford Health Plan
| Professional | $198.51 | $333.73 | $470.94 | |
United
| Facility | $821.00 | $821.00 | $821.00 |