| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.48 | $307.48 | $1,408.96 | |
Medica
| Facility | $409.57 | $609.95 | $3,143.00 | |
Midlands
| Facility | $576.00 | $888.57 | $3,103.79 | |
Sanford Health Plan
| Professional | $422.52 | $564.75 | $664.37 | |
United
| Facility | $3,143.00 | $3,143.00 | $3,143.00 |