| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $181.97 | $281.84 | |
Aetna
| Professional | $134.90 | $181.97 | $234.42 | |
Cigna
| Facility | $478.63 | $478.63 | $478.63 | |
Cigna
| Professional | $288.40 | $478.63 | $588.84 | |
Medica
| Facility | $181.97 | $281.84 | $1,174.90 | |
Medica
| Professional | $104.71 | $104.71 | $295.12 | |
Sanford Health Plan
| Professional | $275.42 | $575.44 | $676.08 | |
United
| Professional | $104.71 | $117.49 | $309.03 | |
Wellmark
| Professional | $245.47 | $245.47 | $245.47 |