| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.43 | $222.61 | $311.38 | |
Aetna
| Professional | $75.52 | $75.52 | $75.52 | |
Cigna
| Professional | $131.75 | $208.24 | $260.30 | |
Hally Health
| Professional | $97.27 | $150.00 | $200.25 | |
Medica
| Facility | $114.43 | $148.76 | $449.18 | |
Medica
| Professional | $68.66 | $76.78 | $289.39 | |
Midlands
| Facility | $137.43 | $217.84 | $250.78 | |
Midlands
| Professional | $137.32 | $217.84 | $291.80 | |
United
| Professional | $68.66 | $68.66 | $249.46 | |
Wellmark
| Professional | $90.40 | $114.43 | $114.43 |