| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.17 | $21.17 | $21.17 | |
Cigna
| Professional | $36.71 | $57.45 | $71.81 | |
Medica
| Facility | $29.83 | $35.78 | $150.10 | |
Medica
| Professional | $16.12 | $28.44 | $47.40 | |
Midlands
| Facility | $37.92 | $55.30 | $62.19 | |
Midlands
| Professional | $37.92 | $55.30 | $69.26 | |
Sanford Health Plan
| Professional | $31.60 | $76.13 | $86.81 | |
United
| Professional | $13.27 | $16.12 | $37.92 | |
Wellmark
| Professional | $31.60 | $31.60 | $31.60 |