| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $212.02 | $212.02 | $251.08 |
Level 4 Drug Administration
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $212.02 | $212.02 | $251.08 |