| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.82 | $48.99 | $751.52 | |
Aetna
| Professional | $10.53 | $23.87 | $206.55 | |
Cigna
| Professional | $39.08 | $60.19 | $116.03 | |
Medica
| Facility | $27.30 | $57.41 | $101.62 | |
Medica
| Professional | $21.17 | $41.32 | $376.33 | |
Midlands
| Facility | $32.09 | $55.48 | $97.28 | |
Midlands
| Professional | $19.14 | $45.84 | $78.06 | |
Sanford Health Plan
| Professional | $34.72 | $46.58 | $86.68 | |
United
| Facility | $821.00 | $821.00 | $821.00 | |
United
| Professional | $21.17 | $40.45 | $70.81 | |
Wellmark
| Professional | $30.00 | $38.40 | $71.40 |