| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.65 | $123.03 | $144.54 | |
Medica
| Facility | $158.49 | $204.17 | $323.59 | |
Midlands
| Professional | $229.09 | $323.59 | $323.59 | |
Sanford Health Plan
| Professional | $199.53 | $275.42 | $323.59 |