| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.57 | $318.02 | $484.50 | |
Aetna
| Professional | $54.27 | $77.81 | $95.76 | |
Cigna
| Professional | $119.63 | $119.63 | $149.53 | |
Medica
| Facility | $94.18 | $129.57 | $543.54 | |
Medica
| Professional | $60.00 | $102.99 | $176.48 | |
Midlands
| Facility | $154.47 | $164.71 | $189.94 | |
Midlands
| Professional | $125.07 | $164.71 | $298.66 | |
Sanford Health Plan
| Professional | $114.43 | $275.70 | $314.36 | |
United
| Professional | $48.06 | $68.66 | $151.05 | |
Wellmark
| Professional | $114.43 | $114.43 | $114.43 |