| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.24 | $103.24 | $103.24 | |
Medica
| Facility | $111.17 | $178.30 | $304.61 | |
Midlands
| Facility | $134.26 | $165.14 | $242.29 | |
Sanford Health Plan
| Professional | $126.14 | $173.43 | $201.83 |