| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $354.81 | $741.31 | |
Aetna
| Professional | $33.11 | $93.33 | $239.88 | |
Cigna
| Professional | $67.61 | $93.33 | $269.15 | |
Medica
| Facility | $48.98 | $95.50 | $281.84 | |
Medica
| Professional | $64.57 | $83.18 | $645.65 | |
Midlands
| Professional | $40.74 | $43.65 | $144.54 | |
Midlands
| Professional | $41.69 | $41.69 | $109.65 | |
Sanford Health Plan
| Professional | $57.54 | $123.03 | $194.98 | |
United
| Facility | $812.83 | $812.83 | $812.83 | |
United
| Professional | $19.95 | $64.57 | $117.49 | |
Wellmark
| Professional | $43.65 | $56.23 | $158.49 |