| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1.02 | $3.80 | $11.48 | |
Medica
| Facility | $3.55 | $15.49 | $489.78 |
Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1.02 | $3.80 | $11.48 | |
Medica
| Facility | $3.55 | $15.49 | $489.78 |