| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $1,013.76 | $4,759.02 | $29,001.53 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 |
Self-administrable drugs not requiring detailed coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HealthNet
| Facility | $1,013.76 | $4,759.02 | $29,001.53 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 |