| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.79 | $161.15 | $161.15 | |
Aetna
| Professional | $128.72 | $146.79 | $161.15 | |
Cigna
| Professional | $310.81 | $377.08 | $471.36 | |
Medica
| Facility | $184.91 | $259.27 | $438.18 | |
Medica
| Professional | $182.64 | $398.43 | $1,516.65 | |
Midlands
| Facility | $325.00 | $388.64 | $508.91 | |
Midlands
| Professional | $314.58 | $388.64 | $480.46 | |
Sanford Health Plan
| Professional | $191.78 | $269.45 | $345.44 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $197.07 | $307.17 | $477.82 | |
Wellmark
| Professional | $290.50 | $355.40 | $387.40 |