| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.22 | $78.90 | $78.90 | |
United
| Professional | $125.64 | $125.64 | $128.22 |
NOC drugs, other than inhalation drugs, administered through DME
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.22 | $78.90 | $78.90 | |
United
| Professional | $125.64 | $125.64 | $128.22 |