| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.82 | $115.82 | $115.82 | |
Aetna
| Professional | $97.20 | $113.12 | $123.94 | |
Cigna
| Professional | $138.00 | $178.88 | $223.59 | |
Medica
| Facility | $100.95 | $133.85 | $245.91 | |
Medica
| Professional | $139.24 | $221.52 | $920.30 | |
Midlands
| Facility | $162.01 | $215.02 | $295.36 | |
Midlands
| Professional | $162.01 | $206.50 | $313.20 | |
Sanford Health Plan
| Professional | $149.31 | $210.06 | $299.92 | |
United
| Professional | $139.24 | $221.17 | $265.82 | |
Wellmark
| Professional | $153.69 | $186.20 | $237.90 |