| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $15.14 | $15.14 | $15.14 | |
Providence
| Facility | $13.18 | $13.49 | $15.14 | |
United
| Professional | $15.85 | $15.85 | $15.85 |
Injection, amphotericin B cholesteryl sulfate complex, 10 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $15.14 | $15.14 | $15.14 | |
Providence
| Facility | $13.18 | $13.49 | $15.14 | |
United
| Professional | $15.85 | $15.85 | $15.85 |