| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.67 | $27.67 | $34.59 | |
MVP Health Care
| Professional | $15.05 | $27.67 | $34.59 | |
United
| Professional | $52.00 | $52.00 | $180.87 |
Antidepressants Tricyclic Other Cyclicals 6/More
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.67 | $27.67 | $34.59 | |
MVP Health Care
| Professional | $15.05 | $27.67 | $34.59 | |
United
| Professional | $52.00 | $52.00 | $180.87 |