| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $23.95 | $23.95 | $29.94 | |
Medica
| Facility | $16.86 | $50.00 | $50.00 |
Antidepressants Tricyclic Other Cyclicals 3-5
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $23.95 | $23.95 | $29.94 | |
Medica
| Facility | $16.86 | $50.00 | $50.00 |