| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.31 | $6.31 | $10.58 | |
Cigna
| Professional | $4.76 | $4.76 | $4.76 | |
MVP Health Care
| Professional | $4.76 | $4.76 | $4.76 | |
United
| Professional | $3.88 | $4.76 | $7.32 |
Injection Thiethylperazine Maleate Up To 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.31 | $6.31 | $10.58 | |
Cigna
| Professional | $4.76 | $4.76 | $4.76 | |
MVP Health Care
| Professional | $4.76 | $4.76 | $4.76 | |
United
| Professional | $3.88 | $4.76 | $7.32 |