| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.44 | $72.44 | $72.44 | |
Sanford Health Plan
| Professional | $5.01 | $5.01 | $5.01 | |
United
| Professional | $27.54 | $27.54 | $34.67 |
Vaccinia immune globulin, human, for intramuscular use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.44 | $72.44 | $72.44 | |
Sanford Health Plan
| Professional | $5.01 | $5.01 | $5.01 | |
United
| Professional | $27.54 | $27.54 | $34.67 |