| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $289.43 | $289.43 | $2,290.00 | |
Medica
| Facility | $391.68 | $511.36 | $831.94 | |
Midlands
| Facility | $470.37 | $705.24 | $987.56 | |
Sanford Health Plan
| Professional | $394.85 | $545.97 | $626.85 | |
Sanford Health Plan
| Professional | AS | $119.94 | $119.94 | $119.94 |
United
| Facility | $821.00 | $821.00 | $821.00 |