| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $708.00 | $708.00 | $708.00 | |
Cigna
| Facility | $495.48 | $495.48 | $495.48 | |
Cigna
| Professional | $356.73 | $451.08 | $563.86 | |
Medica
| Facility | $234.55 | $281.39 | $456.21 | |
Medica
| Professional | $126.74 | $149.11 | $541.54 | |
Midlands
| Facility | $320.68 | $454.46 | $544.62 | |
Midlands
| Professional | $298.20 | $454.46 | $544.62 | |
Sanford Health Plan
| Professional | $355.37 | $598.74 | $682.71 | |
United
| Professional | $104.37 | $126.74 | $248.51 | |
Wellmark
| Professional | $248.51 | $248.51 | $248.51 |