| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.36 | $365.88 | $365.88 | |
Medica
| Facility | $107.04 | $310.39 | $594.67 | |
Midlands
| Facility | $162.40 | $272.31 | $849.10 | |
Sanford Health Plan
| Professional | $123.18 | $349.86 | $645.61 | |
United
| Facility | $821.00 | $821.00 | $821.00 |