| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.32 | $503.97 | $503.97 | |
Medica
| Facility | $20.98 | $32.67 | $60.35 | |
Midlands
| Facility | $33.70 | $50.64 | $67.78 | |
Sanford Health Plan
| Professional | $26.99 | $35.97 | $41.40 | |
United
| Facility | $821.00 | $821.00 | $821.00 |