| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.76 | $66.76 | $66.76 | |
Aetna
| Professional | $66.76 | $66.76 | $69.20 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Injection, sirolimus protein-bound particles, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.76 | $66.76 | $66.76 | |
Aetna
| Professional | $66.76 | $66.76 | $69.20 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |