| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $315.67 | $315.67 | $2,290.00 | |
Medica
| Facility | $427.78 | $537.69 | $876.83 | |
Midlands
| Facility | $514.01 | $742.50 | $878.68 | |
Sanford Health Plan
| Professional | $409.92 | $561.73 | $640.42 | |
United
| Facility | $821.00 | $821.00 | $821.00 |