| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $338.84 | $416.87 | $524.81 | |
Medica
| Professional | $1,174.90 | $1,174.90 | $1,174.90 | |
Midlands
| Professional | $288.40 | $288.40 | $288.40 | |
Midlands
| Professional | $288.40 | $288.40 | $288.40 | |
Sanford Health Plan
| Professional | $112.20 | $288.40 | $380.19 |