| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
DeanCare
| Facility | $12.30 | $12.30 | $26.92 | |
Medica
| Facility | $12.30 | $12.30 | $26.92 | |
Quartz
| Facility | $60.26 | $60.26 | $123.03 |
Drug Scr Qual 1 Drug Class Meth Ea Drug Class
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
DeanCare
| Facility | $12.30 | $12.30 | $26.92 | |
Medica
| Facility | $12.30 | $12.30 | $26.92 | |
Quartz
| Facility | $60.26 | $60.26 | $123.03 |