| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $199.53 | |
Aetna
| Professional | $117.49 | $131.83 | $199.53 | |
Cigna
| Facility | $331.13 | $331.13 | $331.13 | |
Cigna
| Professional | $245.47 | $331.13 | $416.87 | |
Medica
| Facility | $165.96 | $199.53 | $323.59 | |
Medica
| Professional | $89.13 | $104.71 | $870.96 | |
Midlands
| Professional | $208.93 | $208.93 | $208.93 | |
Sanford Health Plan
| Professional | $251.19 | $407.38 | $478.63 | |
United
| Professional | $74.13 | $104.71 | $199.53 | |
Wellmark
| Professional | $173.78 | $173.78 | $173.78 |