| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $876.59 | $876.59 | $4,338.00 | |
Medica
| Facility | $1,128.14 | $1,481.44 | $2,483.30 | |
Midlands
| Facility | $1,602.00 | $2,423.35 | $4,555.17 | |
Sanford Health Plan
| Professional | $1,161.18 | $1,545.65 | $1,799.68 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |