| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,803.13 | $4,966.62 | $5,147.72 | |
Providence
| Facility | $1,027.30 | $1,027.30 | $1,027.30 | |
United
| Professional | $889.25 | $889.25 | $889.25 |
Pegaptanib Sodium Injection
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,803.13 | $4,966.62 | $5,147.72 | |
Providence
| Facility | $1,027.30 | $1,027.30 | $1,027.30 | |
United
| Professional | $889.25 | $889.25 | $889.25 |