| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.79 | $49.79 | $49.79 | |
Aetna
| Professional | $41.69 | $47.75 | $61.23 | |
Cigna
| Professional | $59.25 | $79.16 | $111.56 | |
Medica
| Facility | $43.39 | $64.84 | $104.18 | |
Medica
| Professional | $55.57 | $88.41 | $442.17 | |
Midlands
| Facility | $69.30 | $92.15 | $126.57 | |
Midlands
| Professional | $69.30 | $82.20 | $124.68 | |
Sanford Health Plan
| Professional | $64.05 | $94.30 | $148.72 | |
United
| Professional | $55.57 | $95.54 | $117.99 | |
Wellmark
| Professional | $66.00 | $79.90 | $118.00 |