| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $293.10 | $293.10 | $293.10 | |
Medica
| Facility | $389.76 | $495.34 | $899.94 | |
Midlands
| Facility | $554.00 | $846.37 | $1,759.36 | |
Sanford Health Plan
| Professional | $401.76 | $536.70 | $631.37 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |