| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.14 | $15.14 | $18.20 | |
Aetna
| Professional | $10.00 | $12.02 | $19.05 | |
Cigna
| Facility | $30.20 | $30.20 | $30.20 | |
Cigna
| Professional | $18.20 | $30.20 | $38.02 | |
Medica
| Facility | $15.14 | $18.62 | $45.71 | |
Medica
| Professional | $8.32 | $8.32 | $19.05 | |
Sanford Health Plan
| Professional | $22.91 | $33.11 | $43.65 | |
United
| Professional | $6.76 | $9.55 | $20.89 | |
Wellmark
| Professional | $15.85 | $15.85 | $15.85 |