| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $28.18 | $28.18 | $28.18 | |
Cigna
| Professional | $16.98 | $28.18 | $35.48 | |
Medica
| Facility | $16.98 | $44.67 | $100.00 | |
Sanford Health Plan
| Professional | $24.55 | $26.92 | $26.92 |