| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $14.85 | $64.09 | $207.25 | |
United
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |
Pharmacy - IV Solutions
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $14.85 | $64.09 | $207.25 | |
United
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |