| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $55.00 | $78.00 | $1,500.00 |
NOC drugs, other than inhalation drugs, administered through DME
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $55.00 | $78.00 | $1,500.00 |