| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,658.34 | $1,658.34 | $1,658.34 | |
Medica
| Facility | $2,000.00 | $2,802.59 | $4,669.20 | |
Midlands
| Facility | $2,630.72 | $4,285.83 | $5,675.10 | |
Sanford Health Plan
| Professional | $2,303.76 | $3,129.02 | $3,616.17 | |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |