| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $30.68 | $30.68 | $30.68 | |
Cigna
| Professional | $17.52 | $27.42 | $34.27 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Facility | $18.35 | $27.96 | $33.32 | |
Midlands
| Professional | $19.73 | $33.32 | $39.90 | |
Sanford Health Plan
| Professional | $15.29 | $36.84 | $42.00 |