| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.73 | $2.73 | $4.59 | |
Cigna
| Professional | $2.73 | $2.73 | $6.46 | |
United
| Professional | $1.09 | $2.73 | $17.64 |
Formoterol fumarate, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, 20 mcg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.73 | $2.73 | $4.59 | |
Cigna
| Professional | $2.73 | $2.73 | $6.46 | |
United
| Professional | $1.09 | $2.73 | $17.64 |