| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $439.83 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Horizon BCBS
| Professional | $61.20 | $61.20 | $72.00 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $439.83 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Horizon BCBS
| Professional | $61.20 | $61.20 | $72.00 |