| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.58 | $25.58 | $61.29 | |
Medica
| Facility | $32.28 | $55.84 | $126.87 | |
Midlands
| Facility | $51.08 | $90.60 | $137.77 | |
Sanford Health Plan
| Professional | $33.28 | $55.91 | $104.15 |