| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $703.08 | $703.08 | $703.08 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |
Other Imaging Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $703.08 | $703.08 | $703.08 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |