| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sanford Health Plan
| Professional | $5.18 | $5.18 | $5.18 |
Inj Pantoprazole Sodium, Via
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sanford Health Plan
| Professional | $5.18 | $5.18 | $5.18 |