| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $62.95 | $62.95 | $62.95 | |
Oscar Health
| Facility | $420.68 | $441.84 | $1,003.93 |
Pharmacy - Non-Generic Drugs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $62.95 | $62.95 | $62.95 | |
Oscar Health
| Facility | $420.68 | $441.84 | $1,003.93 |