| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $378.90 | $515.23 | $3,049.20 | |
Medica
| Facility | $403.44 | $659.40 | $1,314.89 | |
Midlands
| Facility | $761.04 | $1,221.45 | $2,532.54 | |
Sanford Health Plan
| Professional | $532.91 | $795.69 | $1,021.85 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |