| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.26 | $91.26 | $91.26 | |
Medica
| Facility | $77.87 | $141.01 | $270.19 | |
Midlands
| Facility | $120.93 | $134.88 | $170.71 | |
Sanford Health Plan
| Professional | $110.14 | $152.87 | $179.84 |