| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,503.90 | $1,503.90 | $4,338.00 | |
Medica
| Facility | $1,555.84 | $2,541.59 | $4,170.02 | |
Midlands
| Facility | $2,485.00 | $3,940.75 | $5,269.25 | |
Sanford Health Plan
| Professional | $1,824.16 | $2,491.05 | $2,930.46 | |
United
| Facility | $4,500.00 | $4,500.00 | $4,500.00 |