| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,410.00 | $1,410.00 | $4,338.00 | |
Medica
| Facility | $1,411.93 | $2,382.90 | $3,899.93 | |
Midlands
| Facility | $2,299.00 | $3,680.09 | $5,269.25 | |
Sanford Health Plan
| Professional | $1,701.34 | $2,325.53 | $2,735.74 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |