| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.21 | $46.21 | $55.30 | |
Aetna
| Professional | $39.22 | $46.21 | $55.30 | |
Cigna
| Professional | $108.30 | $112.26 | $135.37 | |
Medica
| Facility | $39.67 | $53.40 | $98.48 | |
Medica
| Professional | $67.97 | $111.69 | $376.47 | |
Midlands
| Facility | $71.81 | $98.91 | $117.19 | |
Midlands
| Professional | $70.25 | $100.38 | $117.19 | |
Sanford Health Plan
| Professional | $58.94 | $81.39 | $115.15 | |
United
| Professional | $67.97 | $104.24 | $123.58 | |
Wellmark
| Professional | $59.50 | $72.09 | $86.80 |