| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.39 | $0.39 | $0.39 | |
Cigna
| Professional | $0.41 | $0.41 | $0.41 | |
Providence
| Professional | $0.41 | $0.41 | $0.48 | |
United
| Professional | $1.05 | $1.05 | $1.05 |
Injection, theophylline, per 40 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.39 | $0.39 | $0.39 | |
Cigna
| Professional | $0.41 | $0.41 | $0.41 | |
Providence
| Professional | $0.41 | $0.41 | $0.48 | |
United
| Professional | $1.05 | $1.05 | $1.05 |