| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $28.18 | $36.31 | $39.81 | |
United
| Professional | $8.91 | $25.70 | $41.69 |
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $28.18 | $36.31 | $39.81 | |
United
| Professional | $8.91 | $25.70 | $41.69 |