| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.72 | $49.72 | $63.03 | |
Aetna
| Professional | $40.64 | $51.18 | $63.03 | |
Cigna
| Professional | $94.91 | $120.06 | $153.62 | |
Medica
| Facility | $42.70 | $61.39 | $109.33 | |
Medica
| Professional | $64.86 | $124.92 | $427.68 | |
Midlands
| Facility | $77.15 | $106.50 | $135.78 | |
Midlands
| Professional | $88.62 | $109.96 | $147.72 | |
Sanford Health Plan
| Professional | $66.80 | $87.43 | $130.47 | |
United
| Professional | $76.48 | $124.92 | $144.99 | |
Wellmark
| Professional | $64.00 | $77.50 | $99.40 |