| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $62.49 | $77.89 | $93.80 | |
Cigna
| Professional | $103.72 | $165.95 | $222.65 | |
Medica
| Facility | $76.08 | $131.63 | $199.53 | |
Medica
| Professional | $117.51 | $186.95 | $721.97 | |
Midlands
| Facility | $137.86 | $168.26 | $202.38 | |
Midlands
| Professional | $124.81 | $170.10 | $199.79 | |
Sanford Health Plan
| Professional | $101.32 | $148.07 | $198.60 | |
United
| Professional | $101.49 | $170.93 | $202.53 | |
Wellmark
| Professional | $119.70 | $123.30 | $149.69 |