| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $76.16 | $350.20 | $907.12 |
Radiology Therapeutic and/or Chemotherapy Administration-Chemotherapy-Oral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $76.16 | $350.20 | $907.12 |