| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.97 | $158.97 | $158.97 | |
Medica
| Facility | $199.56 | $264.49 | $403.93 | |
Midlands
| Facility | $303.25 | $367.72 | $404.38 | |
Sanford Health Plan
| Professional | $203.55 | $267.25 | $304.69 | |
United
| Facility | $821.00 | $821.00 | $821.00 |