| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 |
Unspecified Oral Dosage Form, Fda Approved Prescription Antieme
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 |