| 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 | $27.67 | $27.67 | $34.59 |
Antidepressants Tricyclic Other Cyclicals 6/More
| 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 | $27.67 | $27.67 | $34.59 |