| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.81 | $54.95 | $54.95 |
Aetna
| Professional | $100.00 | $134.90 | $281.84 | |
Cigna
| Professional | $208.93 | $263.03 | $331.13 | |
Medica
| Professional | $104.71 | $158.49 | $1,548.82 | |
Midlands
| Professional | $234.42 | $251.19 | $269.15 | |
Midlands
| Professional | 26 | $117.49 | $120.23 | $134.90 |
Midlands
| Professional | $251.19 | $251.19 | $251.19 | |
Sanford Health Plan
| Professional | $154.88 | $199.53 | $213.80 | |
Sanford Health Plan
| Professional | 26 | $74.13 | $93.33 | $107.15 |
United
| Professional | $134.90 | $190.55 | $257.04 | |
Wellmark
| Professional | $190.55 | $223.87 | $223.87 |