| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.50 | $376.54 | $376.54 | |
Medica
| Facility | $81.77 | $301.88 | $636.35 | |
Midlands
| Facility | $143.28 | $502.92 | $1,057.42 | |
Sanford Health Plan
| Professional | $95.68 | $337.68 | $604.20 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |