| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.80 | $28.80 | $28.80 | |
Aetna
| Professional | $28.80 | $28.80 | $30.60 |
Injection, plasminogen, human-tvmh, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.80 | $28.80 | $28.80 | |
Aetna
| Professional | $28.80 | $28.80 | $30.60 |