| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1.29 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |
Injection, kanamycin sulfate, up to 75 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $1.29 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |