| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $183.37 | $183.37 | $183.37 |
Midlands
| Facility | 26 | $640.74 | $640.74 | $640.74 |
Sanford Health Plan
| Professional | 26 | $236.12 | $316.50 | $350.62 |
Ct Guidance &Monitoring Visc Tiss Ablation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $183.37 | $183.37 | $183.37 |
Midlands
| Facility | 26 | $640.74 | $640.74 | $640.74 |
Sanford Health Plan
| Professional | 26 | $236.12 | $316.50 | $350.62 |