| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.82 | $186.82 | $186.82 | |
Aetna
| Professional | $149.06 | $186.82 | $198.74 | |
Cigna
| Professional | $207.38 | $207.38 | $259.22 | |
Medica
| Facility | $187.57 | $225.04 | $944.02 | |
Medica
| Professional | $104.21 | $178.87 | $306.51 | |
Midlands
| Facility | $268.30 | $286.08 | $329.90 | |
Midlands
| Professional | $259.76 | $286.08 | $518.71 | |
Sanford Health Plan
| Professional | $198.74 | $478.82 | $545.98 | |
United
| Professional | $83.47 | $119.24 | $238.49 | |
Wellmark
| Professional | $198.74 | $198.74 | $198.74 |