| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.13 | $237.82 | $237.82 | |
Medica
| Facility | $113.11 | $238.59 | $424.57 | |
Midlands
| Facility | $200.12 | $416.13 | $873.61 | |
Sanford Health Plan
| Professional | $116.72 | $241.24 | $430.84 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |