| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $66.07 | $83.18 | $104.71 | |
Medica
| Facility | $41.69 | $79.43 | $134.90 | |
Medica
| Professional | $1,584.89 | $1,584.89 | $1,584.89 | |
Sanford Health Plan
| Professional | $46.77 | $48.98 | $79.43 |