| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.16 | $91.16 | $2,290.00 | |
Medica
| Facility | $102.56 | $164.70 | $283.38 | |
Midlands
| Facility | $155.29 | $232.90 | $319.12 | |
Sanford Health Plan
| Professional | $127.07 | $175.22 | $201.19 | |
United
| Facility | $821.00 | $821.00 | $821.00 |