| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $18.64 | $18.64 | $18.64 | |
United
| Professional | $19.39 | $20.72 | $31.08 | |
University Health Alliance
| Professional | $12.33 | $14.97 | $20.70 |
Injection, chloroquine HCl, up to 250 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $18.64 | $18.64 | $18.64 | |
United
| Professional | $19.39 | $20.72 | $31.08 | |
University Health Alliance
| Professional | $12.33 | $14.97 | $20.70 |