| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.88 | $96.88 | $2,290.00 | |
Medica
| Facility | $119.85 | $163.97 | $269.52 | |
Midlands
| Facility | $222.52 | $272.93 | $917.51 | |
Sanford Health Plan
| Professional | $131.72 | $178.12 | $208.30 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |