| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $50.12 | $75.86 |
Unclassified drug or biological used for ESRD on dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $50.12 | $75.86 |