| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.39 | $9.39 | $9.39 | |
Harvard Pilgrim
| Professional | $371.21 | $371.21 | $371.21 | |
Martin's Point
| Professional | $9.39 | $9.39 | $20.00 |
Drugs Or Medicaments Dispensed In The Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.39 | $9.39 | $9.39 | |
Harvard Pilgrim
| Professional | $371.21 | $371.21 | $371.21 | |
Martin's Point
| Professional | $9.39 | $9.39 | $20.00 |