| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.58 | $124.58 | $3,511.00 | |
Medica
| Facility | $118.05 | $193.27 | $368.27 | |
Midlands
| Facility | $261.27 | $289.29 | $369.18 | |
Sanford Health Plan
| Professional | $154.38 | $203.70 | $232.24 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |