| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.07 | $8.07 | $13.54 | |
United
| Professional | $8.07 | $9.49 | $14.60 |
Injection Dyphylline Up To 500 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.07 | $8.07 | $13.54 | |
United
| Professional | $8.07 | $9.49 | $14.60 |