| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $6,165.95 | $6,165.95 | $6,165.95 | |
Cigna
| Professional | $4,570.88 | $6,165.95 | $7,762.47 | |
Medica
| Professional | $11,748.98 | $11,748.98 | $11,748.98 | |
Sanford Health Plan
| Professional | $4,168.69 | $5,888.44 | $5,888.44 |