| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $1,621.81 | $4,265.80 | $16,218.10 | |
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 |
Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $1,621.81 | $4,265.80 | $16,218.10 | |
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 |