| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.20 | $76.16 | $89.60 | |
Medica
| Facility | $102.45 | $151.41 | $227.63 | |
Midlands
| Facility | $140.69 | $206.24 | $285.57 | |
Sanford Health Plan
| Professional | $137.49 | $178.23 | $226.69 |