| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.98 | $5.98 | $10.02 | |
Cigna
| Professional | $6.17 | $6.17 | $6.17 | |
MVP Health Care
| Professional | $6.17 | $6.17 | $6.17 | |
United
| Professional | $10.37 | $12.93 | $18.77 |
Injection Dolasetron Mesylate 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.98 | $5.98 | $10.02 | |
Cigna
| Professional | $6.17 | $6.17 | $6.17 | |
MVP Health Care
| Professional | $6.17 | $6.17 | $6.17 | |
United
| Professional | $10.37 | $12.93 | $18.77 |