| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1.52 | $6.83 | $339.56 | |
United
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1.52 | $6.83 | $339.56 | |
United
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |