| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.01 | $34.01 | $34.01 | |
Aetna
| Professional | $19.00 | $28.21 | $245.00 | |
Cigna
| Professional | $65.09 | $65.75 | $82.67 | |
Medica
| Facility | $19.00 | $34.01 | $51.02 | |
Medica
| Professional | $68.03 | $143.91 | $259.38 | |
Midlands
| Facility | $60.86 | $60.86 | $71.79 | |
Midlands
| Professional | $60.86 | $60.86 | $60.86 | |
Sanford Health Plan
| Professional | $41.98 | $41.98 | $41.98 | |
United
| Professional | $50.95 | $92.14 | $127.38 | |
Wellmark
| Professional | $38.20 | $38.20 | $38.20 |