| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $26.48 | $34.93 | $40.90 | |
United
| Professional | $8.99 | $8.99 | $41.49 |
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 | $26.48 | $34.93 | $40.90 | |
United
| Professional | $8.99 | $8.99 | $41.49 |