| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.26 | $60.26 | $74.13 | |
Aetna
| Professional | $42.66 | $50.12 | $77.62 | |
Cigna
| Professional | $74.13 | $123.03 | $154.88 | |
Medica
| Facility | $60.26 | $61.66 | $309.03 | |
Medica
| Professional | $33.11 | $33.11 | $77.62 | |
Sanford Health Plan
| Professional | $91.20 | $151.36 | $177.83 | |
United
| Professional | $26.92 | $38.90 | $85.11 | |
Wellmark
| Professional | $64.57 | $64.57 | $64.57 |