| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.47 | $56.47 | $56.47 | |
Medica
| Facility | $821.00 | $821.00 | $821.00 | |
Sanford Health Plan
| Professional | $232.80 | $232.80 | $232.80 | |
United
| Facility | $821.00 | $821.00 | $821.00 |