| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.02 | $138.02 | $156.59 | |
Aetna
| Professional | $87.52 | $109.61 | $156.59 | |
Cigna
| Professional | $163.50 | $163.50 | $204.38 | |
Medica
| Facility | $144.88 | $177.31 | $743.80 | |
Medica
| Professional | $82.10 | $140.93 | $241.49 | |
Midlands
| Facility | $211.40 | $225.39 | $259.92 | |
Midlands
| Professional | $192.43 | $225.39 | $408.70 | |
Sanford Health Plan
| Professional | $156.59 | $377.27 | $430.18 | |
United
| Professional | $65.77 | $82.10 | $187.91 | |
Wellmark
| Professional | $156.59 | $156.59 | $156.59 |