| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.40 | $139.90 | $139.90 | |
Medica
| Facility | $118.99 | $187.27 | $247.59 | |
Midlands
| Facility | $210.33 | $301.70 | $1,123.16 | |
Sanford Health Plan
| Professional | $122.99 | $185.10 | $264.58 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |