| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.36 | $251.36 | $251.36 | |
Medica
| Facility | $257.23 | $422.07 | $686.90 | |
Midlands
| Facility | $392.33 | $614.98 | $805.07 | |
Sanford Health Plan
| Professional | $320.58 | $440.95 | $505.88 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |