| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $58.88 | $91.20 | $630.96 | |
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $58.88 | $91.20 | $630.96 | |
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 |