| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $284.88 | $284.88 | $284.88 | |
Medica
| Facility | $300.00 | $481.45 | $808.14 | |
Midlands
| Facility | $468.88 | $698.85 | $895.80 | |
Sanford Health Plan
| Professional | $370.63 | $481.16 | $548.57 | |
United
| Facility | $821.00 | $821.00 | $821.00 |