| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $192.75 | $255.40 | $255.40 | |
Medica
| Facility | $256.54 | $399.72 | $693.73 | |
Midlands
| Facility | $497.70 | $647.61 | $2,103.33 | |
Sanford Health Plan
| Professional | $278.55 | $415.96 | $532.32 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |