| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $112.20 | $354.81 | |
Aetna
| Facility | 25 | $234.42 | $234.42 | $234.42 |
Medica
| Facility | $12.88 | $17.38 | $93.33 | |
Midlands
| Professional | $16.60 | $22.39 | $40.74 | |
Sanford Health Plan
| Professional | $15.49 | $21.88 | $34.67 |