| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.59 | $5.23 | $5.23 | |
Aetna
| Professional | $4.59 | $5.23 | $20.00 | |
Martin's Point
| Facility | $5.23 | $5.23 | $5.23 | |
Martin's Point
| Professional | $3.63 | $5.23 | $20.00 |
Drugs Or Medicaments Dispensed In The Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.59 | $5.23 | $5.23 | |
Aetna
| Professional | $4.59 | $5.23 | $20.00 | |
Martin's Point
| Facility | $5.23 | $5.23 | $5.23 | |
Martin's Point
| Professional | $3.63 | $5.23 | $20.00 |