| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.21 | $103.21 | $103.21 | |
Medica
| Facility | $93.43 | $159.99 | $259.39 | |
Midlands
| Facility | $195.01 | $226.63 | $244.70 | |
Sanford Health Plan
| Professional | $121.96 | $162.84 | $185.66 | |
United
| Facility | $821.00 | $821.00 | $821.00 |