| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Professional | $39,999.60 | $39,999.60 | $39,999.60 | |
Horizon BCBS
| Professional | $1,000,000.00 | $1,000,000.00 | $1,000,000.00 |
Unspecified Oral Dosage Form, Fda Approved Prescription Antieme
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Professional | $39,999.60 | $39,999.60 | $39,999.60 | |
Horizon BCBS
| Professional | $1,000,000.00 | $1,000,000.00 | $1,000,000.00 |