| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 | |
United
| Professional | $8.64 | $8.64 | $8.64 |
Injection Cephalothin Sodium Up To 1 Gram (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 | |
United
| Professional | $8.64 | $8.64 | $8.64 |