| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.91 | $212.91 | $212.91 | |
Medica
| Facility | $235.38 | $379.63 | $661.60 | |
Midlands
| Facility | $362.20 | $540.04 | $741.47 | |
Sanford Health Plan
| Professional | $295.20 | $405.69 | $462.53 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |