| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.70 | $153.94 | $153.94 | |
Medica
| Facility | $94.44 | $174.27 | $345.24 | |
Midlands
| Facility | $222.71 | $318.68 | $1,539.00 | |
Sanford Health Plan
| Professional | $140.15 | $197.95 | $275.58 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |