| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.35 | $31.21 | $31.21 | |
Aetna
| Professional | $21.26 | $23.38 | $32.71 | |
Cigna
| Professional | $51.43 | $68.17 | $92.52 | |
Medica
| Facility | $29.32 | $45.88 | $90.01 | |
Medica
| Professional | $37.65 | $78.94 | $2,582.05 | |
Midlands
| Facility | $52.97 | $71.33 | $86.17 | |
Midlands
| Professional | $53.87 | $68.69 | $87.44 | |
Sanford Health Plan
| Professional | $33.81 | $50.60 | $63.40 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $39.40 | $64.58 | $93.91 | |
Wellmark
| Professional | $43.90 | $53.70 | $71.09 |