| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.18 | $77.62 | $77.62 | |
Aetna
| Professional | $57.54 | $66.07 | $77.62 | |
Cigna
| Professional | $158.49 | $158.49 | $194.98 | |
Medica
| Facility | $60.26 | $75.86 | $151.36 | |
Medica
| Professional | $70.79 | $147.91 | $524.81 | |
Midlands
| Professional | $109.65 | $158.49 | $158.49 | |
Sanford Health Plan
| Professional | $87.10 | $112.20 | $165.96 | |
United
| Professional | $93.33 | $147.91 | $186.21 | |
Wellmark
| Professional | $89.13 | $109.65 | $123.03 |