| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.18 | $97.23 | $279.08 | |
Aetna
| Professional | $11.25 | $23.16 | $187.50 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.18 | $97.23 | $279.08 | |
Aetna
| Professional | $11.25 | $23.16 | $187.50 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |