| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.42 | $61.42 | $510.14 | |
Medica
| Facility | $58.41 | $103.80 | $156.97 | |
Midlands
| Facility | $112.00 | $144.09 | $181.47 | |
Sanford Health Plan
| Professional | $72.94 | $98.63 | $115.15 | |
United
| Facility | $821.00 | $821.00 | $821.00 |