| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 |