| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2.29 | $2.51 | $18.62 | |
Medica
| Facility | $24.55 | $24.55 | $27.54 |
Pharmacy-Other Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2.29 | $2.51 | $18.62 | |
Medica
| Facility | $24.55 | $24.55 | $27.54 |