| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $279.36 | $767.10 | $1,111.64 | |
Well Sense
| Professional | $136.24 | $879.75 | $1,349.46 |
Thiotepa 15 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $279.36 | $767.10 | $1,111.64 | |
Well Sense
| Professional | $136.24 | $879.75 | $1,349.46 |