| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $305.63 | $305.63 | $305.63 | |
Medica
| Facility | $250.42 | $387.37 | $954.85 | |
Midlands
| Facility | $543.82 | $642.35 | $837.27 | |
Sanford Health Plan
| Professional | $351.73 | $521.32 | $613.33 | |
United
| Facility | $821.00 | $821.00 | $821.00 |