| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.30 | $82.30 | $2,290.00 | |
Medica
| Facility | $97.47 | $139.09 | $220.74 | |
Midlands
| Facility | $140.00 | $190.47 | $248.19 | |
Sanford Health Plan
| Professional | $99.66 | $140.15 | $159.78 | |
United
| Facility | $821.00 | $821.00 | $821.00 |