| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $23.44 | $23.44 | $23.44 | |
Cigna
| Professional | $14.13 | $23.44 | $29.51 | |
Medica
| Facility | $13.80 | $33.88 | $100.00 | |
Sanford Health Plan
| Professional | $14.79 | $24.55 | $24.55 |