| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Christus
| Facility | $14.13 | $44.67 | $117.49 | |
Oscar Health
| Facility | $660.69 | $691.83 | $933.25 | |
Providence
| Facility | $275.42 | $275.42 | $275.42 |
Pharmacy Extension of 025X-Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Christus
| Facility | $14.13 | $44.67 | $117.49 | |
Oscar Health
| Facility | $660.69 | $691.83 | $933.25 | |
Providence
| Facility | $275.42 | $275.42 | $275.42 |