| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $6.92 | $14.45 | $100.00 | |
Medica
| Professional | $12.30 | $14.45 | $16.22 | |
United
| Professional | $14.45 | $14.45 | $16.22 |
Injection, immune globulin (Vivaglobin), 100 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $6.92 | $14.45 | $100.00 | |
Medica
| Professional | $12.30 | $14.45 | $16.22 | |
United
| Professional | $14.45 | $14.45 | $16.22 |