| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.93 | $119.93 | $3,073.00 | |
Medica
| Facility | $106.97 | $188.99 | $306.41 | |
Midlands
| Facility | $147.06 | $259.35 | $1,520.70 | |
Sanford Health Plan
| Professional | $109.69 | $159.63 | $214.12 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |