| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.67 | $8.67 | $20.00 | |
Aetna
| Professional | $4.59 | $8.52 | $17.91 | |
Anthem BCBS
| Professional | $18.05 | $21.25 | $25.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |
Drugs Or Medicaments Dispensed In The Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.67 | $8.67 | $20.00 | |
Aetna
| Professional | $4.59 | $8.52 | $17.91 | |
Anthem BCBS
| Professional | $18.05 | $21.25 | $25.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |