| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.67 | $92.55 | $120.89 | |
Aetna
| Professional | $88.98 | $112.60 | $167.75 | |
Cigna
| Professional | $119.00 | $153.35 | $213.28 | |
Medica
| Facility | $102.15 | $120.89 | $204.30 | |
Medica
| Professional | $117.05 | $214.08 | $747.63 | |
Midlands
| Facility | $212.68 | $227.68 | $288.36 | |
Midlands
| Professional | $212.68 | $226.40 | $248.98 | |
Sanford Health Plan
| Professional | $127.32 | $145.56 | $234.82 | |
United
| Professional | $115.88 | $126.47 | $251.85 | |
Wellmark
| Professional | $178.40 | $209.90 | $241.60 |