| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.69 | $41.69 | $72.44 | |
Aetna
| Professional | $41.69 | $41.69 | $41.69 | |
Cigna
| Professional | $48.98 | $81.28 | $102.33 | |
Medica
| Facility | $60.26 | $70.79 | $199.53 | |
Medica
| Professional | $21.38 | $21.38 | $51.29 | |
Sanford Health Plan
| Professional | $60.26 | $97.72 | $117.49 | |
United
| Professional | $17.78 | $25.12 | $56.23 | |
Wellmark
| Professional | $42.66 | $42.66 | $42.66 |