| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $1,741.95 | $1,741.95 | $1,741.95 |
Supchrdl Njx Of Rx Agt W/O Supply Of Medication
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $1,741.95 | $1,741.95 | $1,741.95 |