| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $295.12 | $954.99 | $4,570.88 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $3,981.07 | $3,981.07 | $3,981.07 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $295.12 | $954.99 | $4,570.88 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $3,981.07 | $3,981.07 | $3,981.07 |