| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.84 | $137.44 | $137.44 | |
Medica
| Facility | $113.68 | $213.45 | $415.01 | |
Midlands
| Facility | $231.00 | $355.37 | $1,679.79 | |
Sanford Health Plan
| Professional | $138.41 | $214.62 | $287.87 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |