| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Univera
| Professional | $2.81 | $2.81 | $2.81 |
Hydroxyprogesterone caproate
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Univera
| Professional | $2.81 | $2.81 | $2.81 |