| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.50 | $206.50 | $206.50 | |
Medica
| Facility | $117.45 | $228.40 | $814.39 | |
Midlands
| Facility | $271.45 | $422.28 | $630.91 | |
Sanford Health Plan
| Professional | $192.82 | $268.02 | $511.44 | |
United
| Facility | $821.00 | $821.00 | $821.00 |