| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Regence BlueShield
| Facility | $85.46 | $219.71 | $277.52 | |
United
| Professional | $1.44 | $1.52 | $1.52 |
Injection Codeine Phosphate Per 30 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Regence BlueShield
| Facility | $85.46 | $219.71 | $277.52 | |
United
| Professional | $1.44 | $1.52 | $1.52 |