| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.29 | $69.29 | $69.29 | |
Aetna
| Professional | $56.24 | $69.29 | $78.77 | |
Cigna
| Professional | $69.04 | $83.39 | $116.54 | |
Medica
| Facility | $70.02 | $109.82 | $154.10 | |
Medica
| Professional | $77.84 | $136.24 | $493.61 | |
Midlands
| Facility | $96.23 | $131.97 | $179.84 | |
Midlands
| Professional | $101.20 | $129.08 | $145.32 | |
Sanford Health Plan
| Professional | $93.94 | $127.58 | $150.08 | |
United
| Professional | $69.33 | $131.28 | $155.12 | |
Wellmark
| Professional | $109.80 | $113.10 | $113.10 |