| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $25.12 | $30.20 | $38.02 | |
Cigna
| Professional | $29.51 | $35.48 | $48.98 | |
Medica
| Facility | $24.55 | $38.90 | $64.57 | |
Medica
| Professional | $31.62 | $51.29 | $213.80 | |
Midlands
| Professional | $48.98 | $57.54 | $77.62 | |
Midlands
| Professional | $45.71 | $45.71 | $77.62 | |
Sanford Health Plan
| Professional | $38.02 | $51.29 | $64.57 | |
United
| Professional | $30.90 | $47.86 | $69.18 | |
Wellmark
| Professional | $38.02 | $48.98 | $48.98 |