| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.15 | $82.17 | $82.17 | |
Aetna
| Professional | $94.00 | $112.50 | $187.50 | |
BCBS
| Facility | $0.20 | $0.32 | $0.50 | |
Medica
| Facility | $23.02 | $59.96 | $100.00 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.15 | $82.17 | $82.17 | |
Aetna
| Professional | $94.00 | $112.50 | $187.50 | |
BCBS
| Facility | $0.20 | $0.32 | $0.50 | |
Medica
| Facility | $23.02 | $59.96 | $100.00 |