| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |
Noc For Parenteral Supplies
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.90 | $50.90 | $50.90 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |