| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.27 | $129.27 | $129.27 | |
Medica
| Facility | $129.63 | $168.23 | $2,000.00 | |
Midlands
| Facility | $187.61 | $241.03 | $1,539.34 | |
Sanford Health Plan
| Professional | $125.38 | $201.75 | $243.23 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |