| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $7.98 | $12.36 | $25.52 |
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Professional | $7.98 | $12.36 | $25.52 |