| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.43 | $3.43 | $3.43 | |
Aetna
| Professional | $3.43 | $3.43 | $3.43 | |
Cigna
| Professional | $3.44 | $3.44 | $3.44 | |
United
| Professional | $4.13 | $4.13 | $4.13 |
Injection, tolazoline HCl, up to 25 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.43 | $3.43 | $3.43 | |
Aetna
| Professional | $3.43 | $3.43 | $3.43 | |
Cigna
| Professional | $3.44 | $3.44 | $3.44 | |
United
| Professional | $4.13 | $4.13 | $4.13 |