| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.41 | $184.40 | $379.64 | |
Aetna
| Professional | $43.50 | $57.39 | $75.42 | |
Cigna
| Facility | $124.03 | $124.03 | $124.03 | |
Cigna
| Professional | $71.45 | $112.93 | $141.16 | |
Medica
| Facility | $58.64 | $70.34 | $295.17 | |
Medica
| Professional | $37.28 | $40.70 | $79.81 | |
Midlands
| Facility | $80.19 | $118.53 | $158.63 | |
Midlands
| Professional | $80.19 | $118.53 | $162.19 | |
Sanford Health Plan
| Professional | $62.14 | $149.71 | $170.71 | |
United
| Professional | $26.10 | $40.70 | $74.56 | |
Wellmark
| Professional | $62.14 | $62.14 | $62.14 |