| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.11 | $38.90 | $47.86 | |
Cigna
| Facility | $81.28 | $81.28 | $81.28 | |
Cigna
| Professional | $56.23 | $56.23 | $70.79 | |
Medica
| Facility | $36.31 | $57.54 | $97.72 | |
Medica
| Professional | $19.50 | $22.91 | $288.40 | |
Sanford Health Plan
| Professional | $57.54 | $64.57 | $75.86 | |
United
| Professional | $17.78 | $22.39 | $47.86 | |
Wellmark
| Professional | $40.74 | $40.74 | $40.74 |