| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $13,488.20 | $13,488.20 | $13,488.20 | |
Sanford Health Plan
| Facility | $950.00 | $950.00 | $950.00 |
Deep Vein Thrombophlebitis without CC/MCC
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $13,488.20 | $13,488.20 | $13,488.20 | |
Sanford Health Plan
| Facility | $950.00 | $950.00 | $950.00 |