| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.00 | $47.00 | $47.00 | |
Aetna
| Professional | $37.96 | $47.00 | $53.52 | |
Cigna
| Professional | $47.02 | $56.61 | $78.58 | |
Medica
| Facility | $47.62 | $74.26 | $104.01 | |
Medica
| Professional | $53.14 | $92.91 | $333.27 | |
Midlands
| Facility | $64.92 | $90.43 | $121.76 | |
Midlands
| Professional | $70.31 | $87.61 | $99.68 | |
Sanford Health Plan
| Professional | $64.66 | $86.88 | $102.21 | |
United
| Professional | $48.91 | $84.94 | $103.29 | |
Wellmark
| Professional | $74.80 | $77.00 | $77.00 |