| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $133.16 | $133.16 | $133.16 | |
Cigna
| Facility | $297.02 | $297.02 | $297.02 | |
Cigna
| Professional | $285.49 | $361.00 | $451.25 | |
Medica
| Facility | $140.58 | $225.04 | $364.86 | |
Medica
| Professional | $84.42 | $89.38 | $324.52 | |
Midlands
| Facility | $192.22 | $315.11 | $381.34 | |
Midlands
| Professional | $192.22 | $315.11 | $326.45 | |
Sanford Health Plan
| Professional | $213.01 | $464.08 | $545.98 | |
United
| Professional | $83.47 | $84.42 | $148.96 | |
Wellmark
| Professional | $198.74 | $198.74 | $198.74 |