| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Unspecified oral dosage form, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48-hour dosage regimen
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |