| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $66.98 | $66.98 | $238.82 |
Pharmacy Extension of 025X-Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $66.98 | $66.98 | $238.82 |