| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.84 | $90.84 | $2,290.00 | |
Medica
| Facility | $104.68 | $176.70 | $337.61 | |
Midlands
| Facility | $168.00 | $252.20 | $1,759.36 | |
Sanford Health Plan
| Professional | $121.09 | $161.30 | $186.95 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |