| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $6.27 | $133.29 | $1,596.92 |
Pharmacy Extension of 025X-Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $6.27 | $133.29 | $1,596.92 |