| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.13 | $32.13 | $44.14 | |
Aetna
| Professional | $25.08 | $34.28 | $50.26 | |
Cigna
| Professional | $80.43 | $87.43 | $107.99 | |
Medica
| Facility | $27.36 | $38.36 | $70.86 | |
Medica
| Professional | $42.47 | $69.81 | $298.80 | |
Midlands
| Facility | $49.49 | $68.90 | $95.36 | |
Midlands
| Professional | $57.45 | $73.76 | $124.89 | |
Sanford Health Plan
| Professional | $40.86 | $57.87 | $88.75 | |
United
| Professional | $43.77 | $65.17 | $77.22 | |
Wellmark
| Professional | $41.00 | $49.70 | $69.20 |