| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $15.01 | $15.01 | $15.01 | |
Cigna
| Professional | $9.59 | $15.01 | $18.77 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Facility | $13.75 | $13.75 | $13.75 | |
Midlands
| Professional | $13.75 | $19.63 | $19.63 | |
Sanford Health Plan
| Professional | $10.75 | $12.78 | $15.04 |