| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $134.90 | $162.18 | |
Aetna
| Professional | $95.50 | $107.15 | $169.82 | |
Cigna
| Facility | $275.42 | $275.42 | $275.42 | |
Cigna
| Professional | $199.53 | $275.42 | $338.84 | |
Medica
| Facility | $134.90 | $162.18 | $263.03 | |
Medica
| Professional | $72.44 | $85.11 | $707.95 | |
Midlands
| Professional | $169.82 | $169.82 | $169.82 | |
Sanford Health Plan
| Professional | $204.17 | $331.13 | $389.05 | |
United
| Professional | $60.26 | $85.11 | $162.18 | |
Wellmark
| Professional | $141.25 | $141.25 | $141.25 |