| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.13 | $74.13 | $74.13 | |
Highmark BCBS
| Facility | $109.65 | $109.65 | $109.65 |
NOC drugs, other than inhalation drugs, administered through DME
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.13 | $74.13 | $74.13 | |
Highmark BCBS
| Facility | $109.65 | $109.65 | $109.65 |