| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.10 | $43.10 | $77.28 | |
Aetna
| Professional | $25.71 | $53.35 | $77.28 | |
Cigna
| Professional | $63.38 | $64.01 | $79.22 | |
Medica
| Facility | $26.98 | $60.13 | $133.27 | |
Medica
| Professional | $56.75 | $117.72 | $488.59 | |
Midlands
| Facility | $47.07 | $82.01 | $131.25 | |
Midlands
| Professional | $56.18 | $91.58 | $145.32 | |
Sanford Health Plan
| Professional | $49.51 | $80.44 | $109.33 | |
United
| Professional | $67.09 | $116.74 | $152.50 | |
Wellmark
| Professional | $48.60 | $58.90 | $102.60 |