| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.93 | $91.93 | $2,290.00 | |
Medica
| Facility | $116.96 | $202.90 | $310.75 | |
Midlands
| Facility | $185.87 | $212.77 | $264.37 | |
Sanford Health Plan
| Professional | $117.81 | $158.57 | $214.67 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |