| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $5,011.87 | $5,011.87 | $5,011.87 | |
Cigna
| Professional | $3,715.35 | $5,011.87 | $6,309.57 | |
Medica
| Professional | $8,709.64 | $8,709.64 | $8,709.64 | |
Sanford Health Plan
| Professional | $3,801.89 | $3,801.89 | $3,801.89 |