| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.13 | $109.13 | $3,073.00 | |
Medica
| Facility | $114.56 | $183.98 | $334.21 | |
Midlands
| Facility | $188.29 | $290.99 | $363.96 | |
Sanford Health Plan
| Professional | $150.94 | $199.16 | $227.06 | |
United
| Facility | $821.00 | $821.00 | $821.00 |