| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $199.53 | $245.47 | $309.03 | |
Medica
| Facility | $165.96 | $229.09 | $309.03 | |
Medica
| Professional | $912.01 | $912.01 | $912.01 | |
Sanford Health Plan
| Professional | $120.23 | $120.23 | $120.23 |