| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $48.98 | $61.66 | $77.62 | |
Medica
| Facility | $44.67 | $44.67 | $53.70 | |
Medica
| Professional | $128.82 | $128.82 | $128.82 | |
Sanford Health Plan
| Professional | $28.84 | $34.67 | $44.67 |