| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Facility | $2.09 | $2.09 | $2.09 | |
United
| Facility | $0.12 | $0.12 | $0.12 | |
United
| Professional | $0.28 | $0.38 | $0.38 |
Levalbuterol, inhalation solution, compounded product, administered through DME, concentrated form, 0.5 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $60.26 | $60.26 | $60.26 | |
Providence
| Facility | $2.09 | $2.09 | $2.09 | |
United
| Facility | $0.12 | $0.12 | $0.12 | |
United
| Professional | $0.28 | $0.38 | $0.38 |