| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $8,702.00 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $6.09 | $6.09 | $6.09 |
Ranitidine Hydrochloride Inj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $8,702.00 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $6.09 | $6.09 | $6.09 |