| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.22 | $258.89 | $258.89 | |
Medica
| Facility | $154.47 | $305.48 | $437.52 | |
Midlands
| Facility | $253.54 | $501.44 | $1,123.16 | |
Sanford Health Plan
| Professional | $156.75 | $294.70 | $469.65 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |