| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.35 | $92.72 | $92.72 | |
Aetna
| Professional | $44.71 | $79.56 | $92.72 | |
Cigna
| Professional | $110.73 | $157.47 | $263.92 | |
Medica
| Facility | $71.29 | $130.53 | $241.53 | |
Medica
| Professional | $91.55 | $199.99 | $5,990.92 | |
Midlands
| Facility | $125.06 | $174.14 | $230.26 | |
Midlands
| Professional | $108.78 | $160.78 | $252.42 | |
Sanford Health Plan
| Professional | $91.83 | $136.01 | $182.43 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $81.91 | $164.83 | $256.39 | |
Wellmark
| Professional | $99.00 | $121.10 | $204.60 |