| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.54 | $75.86 | $354.81 | |
Aetna
| Professional | $64.57 | $91.20 | $309.03 | |
Cigna
| Professional | $91.20 | $114.82 | $165.96 | |
Medica
| Facility | $70.79 | $95.50 | $162.18 | |
Medica
| Professional | $97.72 | $162.18 | $630.96 | |
Midlands
| Professional | $158.49 | $194.98 | $245.47 | |
Midlands
| Professional | $141.25 | $141.25 | $173.78 | |
Sanford Health Plan
| Professional | $89.13 | $123.03 | $186.21 | |
United
| Professional | $91.20 | $123.03 | $208.93 | |
Wellmark
| Professional | $123.03 | $151.36 | $190.55 |