| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4.03 | $4.03 | $4.03 | |
Medical Mutual of Ohio
| Facility | $4.03 | $4.03 | $4.03 |
Factor viii pegylated recomb
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4.03 | $4.03 | $4.03 | |
Medical Mutual of Ohio
| Facility | $4.03 | $4.03 | $4.03 |