| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.48 | $82.17 | $785.46 | |
Medica
| Facility | $7.89 | $17.96 | $30.97 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.48 | $82.17 | $785.46 | |
Medica
| Facility | $7.89 | $17.96 | $30.97 |