| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,745.20 | $4,745.20 | $4,745.20 | |
Cigna
| Professional | $3,752.62 | $4,745.20 | $5,931.50 | |
Medica
| Professional | $8,804.60 | $8,804.60 | $8,804.60 | |
Midlands
| Professional | $4,882.78 | $4,882.78 | $4,882.78 | |
Sanford Health Plan
| Professional | $3,773.40 | $3,773.40 | $3,773.40 |