| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.27 | $69.27 | $78.36 | |
Aetna
| Professional | $57.17 | $69.27 | $82.55 | |
Cigna
| Professional | $153.78 | $156.38 | $193.17 | |
Medica
| Facility | $61.69 | $76.87 | $147.57 | |
Medica
| Professional | $89.84 | $147.66 | $530.02 | |
Midlands
| Facility | $108.69 | $144.40 | $160.52 | |
Midlands
| Professional | $122.54 | $157.22 | $202.90 | |
Sanford Health Plan
| Professional | $85.06 | $119.08 | $164.31 | |
United
| Professional | $89.84 | $147.66 | $185.72 | |
Wellmark
| Professional | $90.10 | $109.20 | $123.80 |