| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.17 | $204.17 | $4,365.16 | |
Medica
| Facility | $93.33 | $257.04 | $812.83 | |
Midlands
| Professional | $269.15 | $707.95 | $707.95 | |
Sanford Health Plan
| Professional | $199.53 | $251.19 | $512.86 | |
United
| Facility | $812.83 | $812.83 | $812.83 |