| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $148.94 | $406.60 | $612.17 | |
Medica
| Facility | $154.00 | $292.27 | $701.45 | |
Midlands
| Facility | $347.95 | $473.44 | $914.58 | |
Sanford Health Plan
| Professional | $231.99 | $358.51 | $557.20 | |
United
| Facility | $821.00 | $821.00 | $821.00 |