| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $220.45 | $220.45 | $220.45 | |
Medica
| Facility | $174.45 | $294.82 | $883.88 | |
Midlands
| Facility | $378.94 | $515.27 | $683.93 | |
Sanford Health Plan
| Professional | $274.58 | $389.43 | $555.10 | |
United
| Facility | $821.00 | $821.00 | $821.00 |