| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.94 | $31.94 | $31.94 | |
Aetna
| Professional | $25.84 | $31.94 | $36.40 | |
Cigna
| Professional | $31.84 | $38.64 | $53.64 | |
Medica
| Facility | $32.29 | $50.55 | $70.80 | |
Medica
| Professional | $36.00 | $62.65 | $226.80 | |
Midlands
| Facility | $44.23 | $60.87 | $82.81 | |
Midlands
| Professional | $46.56 | $59.35 | $67.25 | |
Sanford Health Plan
| Professional | $43.51 | $58.84 | $69.22 | |
United
| Professional | $32.21 | $59.84 | $71.23 | |
Wellmark
| Professional | $50.60 | $52.20 | $52.20 |