| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $147.91 | $186.21 | $229.09 | |
Medica
| Facility | $112.20 | $123.03 | $204.17 | |
Medica
| Professional | $416.87 | $416.87 | $416.87 | |
Sanford Health Plan
| Professional | $91.20 | $123.03 | $138.04 |