| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,905.46 | $1,905.46 | $2,398.83 | |
Medica
| Facility | $831.76 | $1,513.56 | $2,398.83 | |
Medica
| Professional | $5,370.32 | $5,370.32 | $5,370.32 | |
Sanford Health Plan
| Professional | $1,122.02 | $1,348.96 | $1,584.89 |