| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.29 | $1.29 | $2.16 | |
United
| Professional | $1.29 | $1.52 | $2.34 |
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
| Professional | $1.29 | $1.29 | $2.16 | |
United
| Professional | $1.29 | $1.52 | $2.34 |