| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Facility | $8.76 | $8.76 | $8.76 | |
UPMC Health Plan
| Professional | $8.76 | $8.76 | $8.76 |
Injection, droperidol and fentanyl citrate, up to 2 ml ampule
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Facility | $8.76 | $8.76 | $8.76 | |
UPMC Health Plan
| Professional | $8.76 | $8.76 | $8.76 |