| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Facility | $56,999.43 | $56,999.43 | $56,999.43 | |
Highmark BCBS
| Facility | $590.85 | $590.85 | $590.85 | |
United
| Facility | $5,500.00 | $5,500.00 | $5,500.00 |
Pharmacy - Drugs Incident to Other Diagnostic Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Facility | $56,999.43 | $56,999.43 | $56,999.43 | |
Highmark BCBS
| Facility | $590.85 | $590.85 | $590.85 | |
United
| Facility | $5,500.00 | $5,500.00 | $5,500.00 |