| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2.43 | $2.43 | $2.43 | |
BCBS
| Professional | $2.35 | $2.43 | $2.43 | |
United
| Professional | $2.24 | $2.24 | $6.19 |
Injection Mannitol 25% In 50 Ml (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $2.43 | $2.43 | $2.43 | |
BCBS
| Professional | $2.35 | $2.43 | $2.43 | |
United
| Professional | $2.24 | $2.24 | $6.19 |