| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.50 | $144.50 | $144.50 | |
Medica
| Facility | $159.71 | $261.00 | $449.12 | |
Midlands
| Facility | $246.69 | $388.01 | $508.91 | |
Sanford Health Plan
| Professional | $202.66 | $275.19 | $313.75 | |
United
| Facility | $821.00 | $821.00 | $821.00 |