| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.50 | $104.84 | $124.37 | |
Aetna
| Professional | $95.28 | $120.20 | $151.06 | |
Cigna
| Professional | $199.94 | $254.16 | $312.88 | |
Medica
| Facility | $111.75 | $124.48 | $216.41 | |
Medica
| Professional | $100.75 | $288.58 | $794.81 | |
Midlands
| Facility | $244.69 | $265.39 | $307.45 | |
Midlands
| Professional | $244.69 | $259.61 | $285.50 | |
Sanford Health Plan
| Professional | $140.51 | $159.24 | $254.23 | |
United
| Professional | $100.75 | $134.41 | $328.41 | |
Wellmark
| Professional | $196.90 | $231.70 | $261.60 |