| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.99 | $23.99 | $30.20 | |
United
| Professional | $10.72 | $15.14 | $36.31 |
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.99 | $23.99 | $30.20 | |
United
| Professional | $10.72 | $15.14 | $36.31 |