| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $65.00 | $124.17 | $124.17 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $65.00 | $124.17 | $124.17 |