| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.98 | $7.94 | $21.88 |
Drugs Or Medicaments Dispensed In The Office For Home Use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.98 | $7.94 | $21.88 |