| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.00 | $6.00 | $6.00 | |
Aetna
| Professional | $6.00 | $6.00 | $6.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
Acetate Conc Sol Per Gallon
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.00 | $6.00 | $6.00 | |
Aetna
| Professional | $6.00 | $6.00 | $6.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |