| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.56 | $173.56 | $173.56 | |
Medica
| Facility | $217.87 | $271.89 | $440.84 | |
Midlands
| Facility | $331.50 | $402.85 | $443.00 | |
Sanford Health Plan
| Professional | $222.21 | $292.20 | $333.15 | |
United
| Facility | $821.00 | $821.00 | $821.00 |