| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $191.25 | $225.00 | $250.00 |
NOC drugs, other than inhalation drugs, administered through DME
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $191.25 | $225.00 | $250.00 |