| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.13 | $153.13 | $2,290.00 | |
Medica
| Facility | $159.74 | $268.66 | $459.73 | |
Midlands
| Facility | $260.50 | $399.29 | $641.64 | |
Sanford Health Plan
| Professional | $196.62 | $278.02 | $316.98 | |
United
| Facility | $821.00 | $821.00 | $821.00 |