| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $5.25 | $19.16 | $26.82 | |
Providence
| Professional | $19.77 | $19.77 | $35.50 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $5.25 | $19.16 | $26.82 | |
Providence
| Professional | $19.77 | $19.77 | $35.50 |