| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |
Unclassified drug or biological used for ESRD on dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Professional | $60.26 | $60.26 | $60.26 |