| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.12 | $92.12 | $2,290.00 | |
Medica
| Facility | $72.06 | $116.77 | $241.27 | |
Midlands
| Facility | $140.18 | $199.18 | $229.20 | |
Sanford Health Plan
| Professional | $96.89 | $146.82 | $169.49 | |
United
| Facility | $821.00 | $821.00 | $821.00 |