| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Alliance Plan
| Facility | $1.22 | $1.36 | $1.36 | |
Health Alliance Plan
| Professional | $1.28 | $1.36 | $1.63 |
Injection, kanamycin sulfate, up to 75 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Alliance Plan
| Facility | $1.22 | $1.36 | $1.36 | |
Health Alliance Plan
| Professional | $1.28 | $1.36 | $1.63 |