| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $265.83 | $265.83 | $265.83 | |
Medica
| Facility | $348.30 | $449.27 | $764.47 | |
Midlands
| Facility | $430.77 | $645.23 | $903.10 | |
Sanford Health Plan
| Professional | $361.78 | $499.31 | $569.27 | |
Sanford Health Plan
| Professional | AS | $110.67 | $110.67 | $110.67 |
United
| Facility | $2,000.00 | $2,000.00 | $2,000.00 |