| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $24,493.93 | $24,493.93 | |
Medica
| Facility | $4,500.00 | $4,500.00 | $4,500.00 | |
Sanford Health Plan
| Professional | $2,271.19 | $2,271.19 | $2,271.19 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |