| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $23.44 | $30.20 | $33.11 | |
United
| Professional | $23.44 | $23.44 | $23.44 |
Antidepressants, tricyclic and other cyclicals; 3-5
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $23.44 | $30.20 | $33.11 | |
United
| Professional | $23.44 | $23.44 | $23.44 |