| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.46 | $161.46 | $161.46 | |
Medica
| Facility | $219.20 | $285.83 | $466.91 | |
Midlands
| Facility | $266.30 | $397.93 | $545.40 | |
Sanford Health Plan
| Professional | $218.57 | $297.32 | $344.47 | |
Sanford Health Plan
| Professional | AS | $66.66 | $66.66 | $66.66 |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |