| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.12 | $1.12 | $1.12 | |
Aetna
| Professional | $0.98 | $0.99 | $1.12 | |
Providence
| Facility | $0.37 | $1.01 | $4.24 | |
United
| Professional | $1.04 | $1.04 | $1.04 |
Glycopyrrolate, inhalation solution, compounded product, administered through DME, concentrated form, per mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.12 | $1.12 | $1.12 | |
Aetna
| Professional | $0.98 | $0.99 | $1.12 | |
Providence
| Facility | $0.37 | $1.01 | $4.24 | |
United
| Professional | $1.04 | $1.04 | $1.04 |