| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.61 | $19.61 | $19.98 | |
Aetna
| Professional | $17.88 | $24.09 | $209.61 | |
Cigna
| Professional | $30.59 | $37.69 | $47.11 | |
Medica
| Facility | $17.19 | $30.22 | $69.44 | |
Medica
| Professional | $26.84 | $68.40 | $371.24 | |
Midlands
| Facility | $38.57 | $43.72 | $57.03 | |
Midlands
| Professional | $36.24 | $42.94 | $99.87 | |
Sanford Health Plan
| Professional | $21.74 | $31.77 | $108.11 | |
United
| Professional | $25.81 | $40.26 | $142.33 | |
Wellmark
| Professional | $36.70 | $44.90 | $45.70 |