| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
ConnectiCare
| Facility | $54,999.45 | $54,999.45 | $54,999.45 |
Drugs Requiring Specific Ident - Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
ConnectiCare
| Facility | $54,999.45 | $54,999.45 | $54,999.45 |