| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.42 | $16.42 | $16.42 | |
Aetna
| Professional | $16.42 | $16.42 | $16.85 | |
Cigna
| Professional | $19.88 | $20.07 | $24.84 | |
Medica
| Facility | $0.11 | $23.48 | $28.48 | |
Medica
| Professional | $5.74 | $16.50 | $28.88 | |
Midlands
| Facility | $18.92 | $19.25 | $22.17 | |
Midlands
| Professional | $14.71 | $21.05 | $36.27 | |
Sanford Health Plan
| Professional | $16.85 | $17.25 | $22.83 | |
United
| Professional | $5.74 | $6.74 | $28.88 | |
Wellmark
| Professional | $17.25 | $17.25 | $17.25 |