| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $743.96 | $743.96 | $743.96 | |
Priority Health
| Facility | $743.96 | $743.96 | $743.96 |
Level 4 Drug Administration
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $743.96 | $743.96 | $743.96 | |
Priority Health
| Facility | $743.96 | $743.96 | $743.96 |