| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $222.59 | $222.59 | $222.59 | |
Medica
| Facility | $221.58 | $397.69 | $629.38 | |
Midlands
| Facility | $342.52 | $578.02 | $3,276.96 | |
Sanford Health Plan
| Professional | $277.60 | $375.39 | $458.65 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |