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Idaho rates for HCPCS 80336

Antidepressants, tricyclic and other cyclicals; 3-5

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.95 / $23.95 / $29.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $55.00 / $78.00