| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2.94 | $2.94 | $2.94 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2.94 | $2.94 | $2.94 |