| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $29.69 | $29.69 | $29.69 |
Aetna
| Professional | 26 | $27.97 | $80.09 | $265.00 |
Cigna
| Professional | 26 | $54.56 | $66.70 | $83.39 |
Medica
| Professional | 26 | $35.02 | $56.34 | $65.42 |
Sanford Health Plan
| Professional | 26 | $37.32 | $48.80 | $55.63 |
United
| Professional | 26 | $33.95 | $40.64 | $63.40 |
Wellmark
| Professional | 26 | $55.20 | $64.90 | $64.90 |