| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $0.03 | $0.85 | $4.49 |
Pharmacy Extension of 025X-Self-Administrable Drugs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $0.03 | $0.85 | $4.49 |