| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.48 | $167.14 | $206.86 | |
Medica
| Professional | $500.00 | $500.00 | $500.00 | |
Midlands
| Facility | $149.46 | $149.46 | $149.46 | |
Midlands
| Professional | $90.00 | $103.74 | $198.39 | |
Sanford Health Plan
| Professional | $83.66 | $164.20 | $226.01 |