| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.28 | $79.04 | $90.44 | |
Aetna
| Professional | $94.00 | $94.00 | $94.00 | |
BCBS
| Facility | $56,799.99 | $68,899.99 | $81,099.99 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.28 | $79.04 | $90.44 | |
Aetna
| Professional | $94.00 | $94.00 | $94.00 | |
BCBS
| Facility | $56,799.99 | $68,899.99 | $81,099.99 |