| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.77 | $73.77 | $73.77 | |
Aetna
| Professional | $73.77 | $73.77 | $73.77 | |
Cigna
| Professional | $75.55 | $75.55 | $75.55 | |
United
| Professional | $84.44 | $88.88 | $88.88 |
Injection Urea Up To 40 Gm (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.77 | $73.77 | $73.77 | |
Aetna
| Professional | $73.77 | $73.77 | $73.77 | |
Cigna
| Professional | $75.55 | $75.55 | $75.55 | |
United
| Professional | $84.44 | $88.88 | $88.88 |