| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.03 | $0.05 | $0.07 | |
Aetna
| Professional | $0.05 | $0.05 | $0.05 | |
Cigna
| Professional | $23.95 | $23.95 | $29.94 |
Antidepressants Tricyclic Other Cyclicals 3-5
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.03 | $0.05 | $0.07 | |
Aetna
| Professional | $0.05 | $0.05 | $0.05 | |
Cigna
| Professional | $23.95 | $23.95 | $29.94 |