| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.16 | $29.16 | $29.16 | |
Medica
| Facility | $100.00 | $100.00 | $159.00 |
Injection, plasminogen, human-tvmh, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.16 | $29.16 | $29.16 | |
Medica
| Facility | $100.00 | $100.00 | $159.00 |