| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $20.01 | $20.01 | $20.01 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $20.01 | $20.01 | $20.01 |