| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $288.94 | $288.94 | $288.94 | |
Sanford Health Plan
| Professional | $11.13 | $11.13 | $11.13 |
Unlisted Immunology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $288.94 | $288.94 | $288.94 | |
Sanford Health Plan
| Professional | $11.13 | $11.13 | $11.13 |