| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.39 | $191.80 | $191.80 | |
Medica
| Facility | $78.89 | $141.96 | $354.90 | |
Midlands
| Facility | $100.70 | $260.38 | $359.46 | |
Sanford Health Plan
| Professional | $93.48 | $211.04 | $354.35 | |
United
| Facility | $1,643.00 | $1,643.00 | $1,643.00 |