| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.39 | $245.39 | $245.39 | |
Medica
| Facility | $306.68 | $406.30 | $616.91 | |
Midlands
| Facility | $466.80 | $562.10 | $618.14 | |
Sanford Health Plan
| Professional | $278.42 | $406.26 | $463.18 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |