| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.53 | $12.53 | $12.53 | |
Aetna
| Professional | $10.40 | $11.64 | $21.95 | |
Cigna
| Professional | $19.95 | $23.26 | $28.79 | |
Medica
| Facility | $9.72 | $13.19 | $25.11 | |
Medica
| Professional | $13.19 | $20.85 | $70.50 | |
Midlands
| Facility | $21.98 | $23.78 | $28.06 | |
Midlands
| Professional | $21.62 | $23.35 | $28.64 | |
Sanford Health Plan
| Professional | $13.20 | $16.39 | $21.99 | |
United
| Professional | $13.19 | $20.85 | $29.98 | |
Wellmark
| Professional | $22.70 | $27.80 | $27.80 |