| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $628.30 | $628.30 | $628.30 | |
Medica
| Facility | $808.48 | $988.60 | $1,775.51 | |
Midlands
| Facility | $1,028.76 | $1,710.66 | $2,152.40 | |
Sanford Health Plan
| Professional | $824.72 | $1,147.08 | $1,349.43 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |