| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Molina
| Professional | $24.00 | $45.00 | $60.00 |
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 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Molina
| Professional | $24.00 | $45.00 | $60.00 |