| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.65 | $73.65 | $73.65 | |
Medica
| Facility | $88.92 | $126.16 | $318.26 | |
Midlands
| Facility | $124.38 | $188.54 | $1,123.16 | |
Sanford Health Plan
| Professional | $97.33 | $132.29 | $167.09 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |