| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.91 | $15.91 | $15.91 | |
Aetna
| Professional | $12.89 | $15.91 | $18.20 | |
Cigna
| Professional | $15.77 | $19.13 | $26.55 | |
Medica
| Facility | $16.13 | $25.47 | $35.32 | |
Medica
| Professional | $18.17 | $31.13 | $113.84 | |
Midlands
| Facility | $22.02 | $31.29 | $41.00 | |
Midlands
| Professional | $23.27 | $29.48 | $33.78 | |
Sanford Health Plan
| Professional | $21.96 | $29.14 | $34.29 | |
United
| Professional | $16.26 | $29.24 | $35.08 | |
Wellmark
| Professional | $25.10 | $25.80 | $25.80 |