| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $48.98 | $102.33 | $134.90 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |
Pharmacy-IV Solutions
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $48.98 | $102.33 | $134.90 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |