| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.81 | $138.78 | $138.78 | |
Medica
| Facility | $124.37 | $178.32 | $237.11 | |
Midlands
| Facility | $214.38 | $297.68 | $1,123.16 | |
Sanford Health Plan
| Professional | $128.77 | $178.18 | $264.58 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |