| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.94 | $165.94 | $2,290.00 | |
Medica
| Facility | $188.68 | $280.44 | $488.91 | |
Midlands
| Facility | $272.73 | $432.13 | $582.96 | |
Sanford Health Plan
| Professional | $223.03 | $322.27 | $367.44 | |
United
| Facility | $821.00 | $821.00 | $821.00 |