| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.08 | $73.08 | $81.18 | |
Aetna
| Professional | $58.93 | $73.08 | $107.93 | |
Cigna
| Professional | $152.10 | $156.65 | $190.13 | |
Medica
| Facility | $62.52 | $76.87 | $148.29 | |
Medica
| Professional | $92.75 | $152.46 | $512.83 | |
Midlands
| Facility | $100.98 | $140.53 | $160.57 | |
Midlands
| Professional | $101.40 | $145.69 | $160.57 | |
Sanford Health Plan
| Professional | $82.23 | $120.58 | $161.72 | |
United
| Professional | $73.93 | $142.30 | $168.64 | |
Wellmark
| Professional | $89.70 | $108.70 | $121.90 |