| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.35 | $6.35 | $6.35 | |
Aetna
| Professional | $3.26 | $6.35 | $22.72 | |
BCBS
| Facility | $310.85 | $377.23 | $507.50 | |
BCBS
| Professional | $21.00 | $21.00 | $21.00 |
Drugs/Medicaments Dispensed Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.35 | $6.35 | $6.35 | |
Aetna
| Professional | $3.26 | $6.35 | $22.72 | |
BCBS
| Facility | $310.85 | $377.23 | $507.50 | |
BCBS
| Professional | $21.00 | $21.00 | $21.00 |