| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $21.50 | $74.14 | $124.17 | |
Midlands
| Professional | $30.00 | $31.06 | $55.88 | |
Sanford Health Plan
| Professional | $28.47 | $28.47 | $28.47 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $21.50 | $74.14 | $124.17 | |
Midlands
| Professional | $30.00 | $31.06 | $55.88 | |
Sanford Health Plan
| Professional | $28.47 | $28.47 | $28.47 |