| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.33 | $65.42 | $98.35 | |
Aetna
| Professional | $55.00 | $94.00 | $150.00 | |
BCBS
| Facility | $64,999.99 | $81,499.99 | $94,999.99 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6.33 | $65.42 | $98.35 | |
Aetna
| Professional | $55.00 | $94.00 | $150.00 | |
BCBS
| Facility | $64,999.99 | $81,499.99 | $94,999.99 |