| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.05 | $11.05 | $11.05 | |
Cigna
| Professional | $11.05 | $11.05 | $11.05 | |
United
| Professional | $10.40 | $13.00 | $19.50 |
Injection Triflupromazine Hcl Up To 20 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.05 | $11.05 | $11.05 | |
Cigna
| Professional | $11.05 | $11.05 | $11.05 | |
United
| Professional | $10.40 | $13.00 | $19.50 |