| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.78 | $221.78 | $221.78 | |
Medica
| Facility | $300.39 | $399.06 | $639.91 | |
Midlands
| Facility | $362.72 | $541.49 | $748.74 | |
Sanford Health Plan
| Professional | $300.64 | $415.90 | $514.63 | |
United
| Facility | $821.00 | $821.00 | $821.00 |