| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.11 | $85.11 | $85.11 | |
Medica
| Facility | $102.33 | $125.89 | $229.09 | |
Midlands
| Professional | $165.96 | $181.97 | $194.98 | |
Sanford Health Plan
| Professional | $95.50 | $138.04 | $162.18 | |
United
| Facility | $812.83 | $812.83 | $812.83 |