| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.33 | $15.49 | $91.20 | |
Cigna
| Facility | $0.12 | $0.12 | $0.12 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 | |
United
| Professional | $0.07 | $0.12 | $0.16 |
Injection, acyclovir, 5 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.33 | $15.49 | $91.20 | |
Cigna
| Facility | $0.12 | $0.12 | $0.12 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 | |
United
| Professional | $0.07 | $0.12 | $0.16 |