| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.38 | $0.38 | $0.47 | |
Medica
| Facility | $0.38 | $0.47 | $0.65 | |
Medica
| Professional | $1.05 | $1.05 | $1.12 | |
United
| Professional | $0.89 | $1.05 | $1.17 |
Injection, theophylline, per 40 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.38 | $0.38 | $0.47 | |
Medica
| Facility | $0.38 | $0.47 | $0.65 | |
Medica
| Professional | $1.05 | $1.05 | $1.12 | |
United
| Professional | $0.89 | $1.05 | $1.17 |