| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.23 | $64.57 | $120.23 | |
Cigna
| Professional | $69.18 | $131.83 | $169.82 | |
Medica
| Facility | $54.95 | $102.33 | $147.91 | |
Medica
| Professional | $79.43 | $117.49 | $467.74 | |
Midlands
| Professional | $104.71 | $144.54 | $147.91 | |
Midlands
| Professional | $117.49 | $169.82 | $169.82 | |
Sanford Health Plan
| Professional | $91.20 | $120.23 | $162.18 | |
United
| Professional | $79.43 | $117.49 | $151.36 | |
Wellmark
| Professional | $144.54 | $151.36 | $151.36 |