| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.54 | $0.54 | $255.74 | |
Aetna
| Professional | $0.54 | $75.00 | $126.75 | |
Cigna
| Professional | $0.56 | $0.56 | $0.56 | |
United
| Professional | $0.46 | $0.48 | $0.48 |
Injection Medroxyprogesterone Acetate 1 Mg (Reinstated) Injection Medroxyprogesterone Acetate 100 Mg Special Coverage Instructions Apply. See Mcm: 2049) (Old Description - Deleted 06/30/2003)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.54 | $0.54 | $255.74 | |
Aetna
| Professional | $0.54 | $75.00 | $126.75 | |
Cigna
| Professional | $0.56 | $0.56 | $0.56 | |
United
| Professional | $0.46 | $0.48 | $0.48 |