| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $154.88 | $194.98 | |
Medica
| Facility | $93.33 | $95.50 | $186.21 | |
Medica
| Professional | $389.05 | $389.05 | $389.05 | |
Sanford Health Plan
| Professional | $72.44 | $89.13 | $123.03 |