| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.10 | $45.10 | $45.10 | |
Aetna
| Professional | $45.10 | $45.10 | $46.75 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Inj., Xipere, 1 Mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.10 | $45.10 | $45.10 | |
Aetna
| Professional | $45.10 | $45.10 | $46.75 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |