| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.49 | $24.49 | $79.19 | |
Medica
| Facility | $21.43 | $61.21 | $160.96 | |
Midlands
| Facility | $48.27 | $135.38 | $173.98 | |
Sanford Health Plan
| Professional | $32.31 | $85.27 | $134.38 |