| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.52 | $8.52 | $34.00 | |
Aetna
| Professional | $4.59 | $8.52 | $9.11 | |
Anthem BCBS
| Professional | $20.00 | $25.00 | $42.15 | |
Molina
| Professional | $40.00 | $50.00 | $50.00 |
Drugs/Medicaments Dispensed Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.52 | $8.52 | $34.00 | |
Aetna
| Professional | $4.59 | $8.52 | $9.11 | |
Anthem BCBS
| Professional | $20.00 | $25.00 | $42.15 | |
Molina
| Professional | $40.00 | $50.00 | $50.00 |