| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.69 | $26.69 | $26.69 | |
Medica
| Facility | $33.49 | $58.78 | $385.54 | |
Midlands
| Facility | $60.76 | $113.33 | $357.14 | |
Sanford Health Plan
| Professional | $36.65 | $49.16 | $281.39 | |
United
| Facility | $821.00 | $821.00 | $821.00 |