| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.03 | $89.03 | $2,290.00 | |
Medica
| Facility | $112.94 | $150.46 | $264.20 | |
Midlands
| Facility | $170.00 | $247.71 | $693.86 | |
Sanford Health Plan
| Professional | $120.23 | $160.72 | $179.84 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |