| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $2,652.47 | $2,652.47 | $7,083.10 |
Pharmacy Extension of 025X-Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Facility | $2,652.47 | $2,652.47 | $7,083.10 |