| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.78 | $13.26 | $13.58 | |
Cigna
| Facility | $13.58 | $13.58 | $13.58 | |
Cigna
| Professional | $13.58 | $13.58 | $13.58 | |
United
| Professional | $1.44 | $1.81 | $3.73 |
Protamine Sulfate For Hemodialysis Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 4270)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.78 | $13.26 | $13.58 | |
Cigna
| Facility | $13.58 | $13.58 | $13.58 | |
Cigna
| Professional | $13.58 | $13.58 | $13.58 | |
United
| Professional | $1.44 | $1.81 | $3.73 |