| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.99 | $45.99 | $46.37 | |
Aetna
| Professional | $42.00 | $45.99 | $66.53 | |
Cigna
| Professional | $70.80 | $87.79 | $109.05 | |
Medica
| Facility | $40.00 | $57.94 | $99.59 | |
Medica
| Professional | $44.23 | $91.22 | $276.67 | |
Midlands
| Facility | $81.58 | $100.71 | $110.74 | |
Midlands
| Professional | $85.57 | $92.91 | $112.87 | |
Sanford Health Plan
| Professional | $49.83 | $70.39 | $83.45 | |
United
| Professional | $44.23 | $79.43 | $93.45 | |
Wellmark
| Professional | $85.40 | $104.50 | $105.30 |