| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.13 | $39.81 | $51.29 | |
Aetna
| Professional | $93.33 | $112.20 | $186.21 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 |
Compounded drug, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.13 | $39.81 | $51.29 | |
Aetna
| Professional | $93.33 | $112.20 | $186.21 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 |