| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1.37 | $2.50 | $18.53 | |
Medica
| Facility | $24.64 | $24.64 | $27.76 |
Pharmacy - Other Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $1.37 | $2.50 | $18.53 | |
Medica
| Facility | $24.64 | $24.64 | $27.76 |