| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $40.74 | $40.74 | $40.74 | |
Cigna
| Professional | $24.55 | $40.74 | $51.29 | |
Medica
| Facility | $23.99 | $60.26 | $100.00 | |
Sanford Health Plan
| Professional | $33.88 | $33.88 | $34.67 |