| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.65 | $142.91 | $791.31 | |
Aetna
| Professional | $60.00 | $94.00 | $187.50 | |
BCBS
| Facility | $0.95 | $1.00 | $1.00 | |
Medica
| Facility | $15.94 | $25.84 | $69.97 |
Compounded Drug, Noc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.65 | $142.91 | $791.31 | |
Aetna
| Professional | $60.00 | $94.00 | $187.50 | |
BCBS
| Facility | $0.95 | $1.00 | $1.00 | |
Medica
| Facility | $15.94 | $25.84 | $69.97 |