| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.36 | $75.36 | $2,290.00 | |
Medica
| Facility | $92.02 | $128.76 | $325.55 | |
Midlands
| Facility | $133.54 | $192.99 | $1,423.56 | |
Sanford Health Plan
| Professional | $97.33 | $131.71 | $175.96 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |