| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.10 | $215.10 | $215.10 | |
Medica
| Facility | $149.84 | $253.23 | $858.85 | |
Midlands
| Facility | $325.42 | $499.96 | $664.15 | |
Sanford Health Plan
| Professional | $248.38 | $333.15 | $539.16 | |
United
| Facility | $821.00 | $821.00 | $821.00 |