| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $302.00 | $380.19 | $467.74 | |
Medica
| Facility | $165.96 | $234.42 | $363.08 | |
Medica
| Professional | $812.83 | $812.83 | $812.83 | |
Sanford Health Plan
| Professional | $177.83 | $213.80 | $213.80 |