| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.45 | $29.45 | $29.45 | |
Aetna
| Professional | $29.45 | $29.45 | $29.45 | |
Cigna
| Professional | $30.08 | $30.08 | $30.08 | |
United
| Professional | $30.08 | $30.08 | $30.08 |
Injection Spectinomycin Dihydrochloride Up To 2 Gm (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.45 | $29.45 | $29.45 | |
Aetna
| Professional | $29.45 | $29.45 | $29.45 | |
Cigna
| Professional | $30.08 | $30.08 | $30.08 | |
United
| Professional | $30.08 | $30.08 | $30.08 |