| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $0.30 | $0.89 | $5.58 | |
Medica
| Facility | $0.51 | $0.51 | $1.10 |
Pharmacy Extension of 025X-Self-Administrable Drugs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $0.30 | $0.89 | $5.58 | |
Medica
| Facility | $0.51 | $0.51 | $1.10 |