| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $95.00 | $95.00 | $95.00 |
Acetylcysteine, inhalation solution, compounded product, administered through DME, unit dose form, per g
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $95.00 | $95.00 | $95.00 |