| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $35.72 | $35.72 | $225.00 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |
Unclassified drug or biological used for ESRD on dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $35.72 | $35.72 | $225.00 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |