| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health New England
| Facility | $5.42 | $5.42 | $22.61 |
Inj Pantoprazole Sodium, Via
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health New England
| Facility | $5.42 | $5.42 | $22.61 |