| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,216.79 | $17,226.00 | $17,226.00 | |
Medica
| Professional | $26,136.00 | $26,136.00 | $26,136.00 |
Procenta, Per 200 Mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,216.79 | $17,226.00 | $17,226.00 | |
Medica
| Professional | $26,136.00 | $26,136.00 | $26,136.00 |