| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $50.00 | $50.00 | |
Pacific Source
| Facility | $25.00 | $25.00 | $25.00 |
Influenza virus vaccine (IIV), pandemic formulation, split virus, for intramuscular use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $50.00 | $50.00 | |
Pacific Source
| Facility | $25.00 | $25.00 | $25.00 |