| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
Cigna
| Professional | $18.62 | $18.62 | $18.62 | |
Providence
| Facility | $19.95 | $21.88 | $40.74 | |
Providence
| Professional | $60.26 | $79.43 | $85.11 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
Cigna
| Professional | $18.62 | $18.62 | $18.62 | |
Providence
| Facility | $19.95 | $21.88 | $40.74 | |
Providence
| Professional | $60.26 | $79.43 | $85.11 |