| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.11 | $23.11 | $23.11 | |
Aetna
| Professional | $11.26 | $12.39 | $30.35 | |
Cigna
| Facility | $24.26 | $24.26 | $39.86 | |
Cigna
| Professional | $42.00 | $42.00 | $52.50 | |
Medica
| Facility | $24.77 | $41.86 | $169.60 | |
Medica
| Professional | $14.44 | $25.80 | $41.42 | |
Midlands
| Facility | $33.14 | $39.86 | $62.59 | |
Midlands
| Professional | $32.65 | $40.42 | $76.17 | |
Sanford Health Plan
| Professional | $30.23 | $35.39 | $42.07 | |
United
| Professional | $12.74 | $18.07 | $30.13 | |
Wellmark
| Professional | $35.52 | $35.52 | $35.52 |