| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.50 | $2.50 | $8.80 | |
Cigna
| Professional | $3.00 | $3.00 | $3.00 | |
MVP Health Care
| Professional | $3.00 | $3.00 | $3.00 |
Supplies For Self-Administered Injections (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.50 | $2.50 | $8.80 | |
Cigna
| Professional | $3.00 | $3.00 | $3.00 | |
MVP Health Care
| Professional | $3.00 | $3.00 | $3.00 |