| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $172.80 | $199.80 | $199.80 | |
Medica
| Facility | $204.92 | $303.61 | $515.88 | |
Midlands
| Facility | $358.00 | $514.35 | $2,896.79 | |
Sanford Health Plan
| Professional | $220.62 | $333.03 | $406.90 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |