| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $467.74 | $467.74 | $467.74 | |
Cigna
| Professional | $354.81 | $467.74 | $588.84 | |
Medica
| Professional | $870.96 | $870.96 | $870.96 | |
Sanford Health Plan
| Professional | $371.54 | $371.54 | $371.54 |