| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $1.38 | $3.65 | $27.74 |
Pharmacy-Other Pharmacy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $1.38 | $3.65 | $27.74 |