| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.20 | $30.20 | $30.20 |
Aetna
| Professional | $208.93 | $245.47 | $346.74 | |
Cigna
| Professional | $436.52 | $549.54 | $691.83 | |
Medica
| Professional | $218.78 | $263.03 | $489.78 | |
Midlands
| Professional | $436.52 | $436.52 | $436.52 | |
Midlands
| Professional | 26 | $75.86 | $75.86 | $75.86 |
Sanford Health Plan
| Professional | $239.88 | $380.19 | $446.68 | |
Sanford Health Plan
| Professional | 26 | $40.74 | $54.95 | $58.88 |
United
| Professional | $229.09 | $389.05 | $512.86 | |
Wellmark
| Professional | $389.05 | $457.09 | $457.09 |