| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $126.75 | $126.75 | $158.44 | |
Medica
| Facility | $165.92 | $165.92 | $165.92 | |
Midlands
| Facility | $200.25 | $200.25 | $200.25 | |
Midlands
| Professional | $200.25 | $200.25 | $200.25 | |
Sanford Health Plan
| Professional | $163.63 | $163.63 | $171.65 |