| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.29 | $57.54 | $102.33 | |
Aetna
| Professional | $52.48 | $64.57 | $109.65 | |
Aetna
| Professional | 25 | $60.26 | $70.79 | $70.79 |
Cigna
| Professional | $134.90 | $154.88 | $169.82 | |
Medica
| Facility | $79.43 | $93.33 | $151.36 | |
Medica
| Professional | $60.26 | $89.13 | $144.54 | |
Midlands
| Professional | $131.83 | $131.83 | $131.83 | |
Sanford Health Plan
| Professional | $75.86 | $114.82 | $144.54 | |
United
| Professional | $60.26 | $123.03 | $162.18 |