| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,315.30 | $1,315.30 | $1,315.30 | |
Medica
| Facility | $1,310.68 | $2,196.14 | $3,862.89 | |
Midlands
| Facility | $2,151.67 | $3,193.55 | $4,266.24 | |
Sanford Health Plan
| Professional | $1,563.55 | $2,302.81 | $2,667.17 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |