| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.41 | $58.41 | $58.41 | |
Aetna
| Professional | $41.63 | $58.41 | $58.41 | |
Cigna
| Professional | $64.88 | $64.88 | $81.09 | |
Medica
| Facility | $58.64 | $70.34 | $295.17 | |
Medica
| Professional | $37.28 | $55.93 | $119.72 | |
Midlands
| Facility | $72.41 | $83.89 | $107.31 | |
Midlands
| Professional | $72.41 | $105.97 | $162.19 | |
Sanford Health Plan
| Professional | $62.14 | $149.71 | $170.71 | |
United
| Professional | $26.10 | $40.70 | $74.56 | |
Wellmark
| Professional | $62.14 | $62.14 | $62.14 |