| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.06 | $268.12 | $268.12 | |
Medica
| Facility | $165.43 | $314.33 | $543.89 | |
Midlands
| Facility | $287.47 | $477.82 | $832.20 | |
Sanford Health Plan
| Professional | $194.11 | $360.04 | $491.64 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |