| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.65 | $109.65 | $109.65 | |
Aetna
| Professional | $87.10 | $100.00 | $120.23 | |
Cigna
| Professional | $131.83 | $173.78 | $218.78 | |
Medica
| Facility | $95.50 | $125.89 | $229.09 | |
Medica
| Professional | $112.20 | $190.55 | $891.25 | |
Midlands
| Professional | $173.78 | $177.83 | $229.09 | |
Sanford Health Plan
| Professional | $141.25 | $199.53 | $309.03 | |
United
| Professional | $125.89 | $208.93 | $323.59 | |
Wellmark
| Professional | $144.54 | $173.78 | $229.09 |