| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.15 | $187.91 | $187.91 | |
Aetna
| Professional | $117.56 | $174.56 | $310.07 | |
Cigna
| Professional | $262.31 | $347.67 | $547.32 | |
Medica
| Facility | $160.57 | $268.89 | $478.24 | |
Medica
| Professional | $195.99 | $425.74 | $1,412.72 | |
Midlands
| Facility | $268.00 | $334.87 | $496.34 | |
Midlands
| Professional | $245.00 | $354.28 | $503.63 | |
Sanford Health Plan
| Professional | $186.31 | $272.98 | $366.15 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $168.25 | $338.20 | $526.09 | |
Wellmark
| Professional | $217.00 | $265.50 | $410.60 |