| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Facility | $57,543.99 | $57,543.99 | $57,543.99 | |
Highmark BCBS
| Facility | $4.57 | $8.71 | $83.18 |
Pharmacy-Nongeneric Drugs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Facility | $57,543.99 | $57,543.99 | $57,543.99 | |
Highmark BCBS
| Facility | $4.57 | $8.71 | $83.18 |