| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $69.90 | $69.90 | $69.90 |
Sanford Health Plan
| Professional | 26 | $86.66 | $114.61 | $130.66 |
Card Bl Pool Plnr Mlt Stdy Wal Motn Eject Fract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $69.90 | $69.90 | $69.90 |
Sanford Health Plan
| Professional | 26 | $86.66 | $114.61 | $130.66 |