| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.24 | $163.24 | $163.24 | |
Aetna
| Professional | $163.24 | $163.24 | $182.82 | |
Cigna
| Professional | $160.50 | $162.11 | $200.63 | |
Medica
| Facility | $233.43 | $275.88 | $447.28 | |
Medica
| Professional | $105.13 | $181.48 | $181.48 | |
Midlands
| Professional | $144.09 | $144.09 | $144.21 | |
Sanford Health Plan
| Professional | $139.00 | $139.00 | $139.00 | |
United
| Professional | $181.48 | $181.48 | $186.43 |