| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.13 | $23.13 | $28.91 | |
Hometown Health
| Professional | $5.09 | $5.09 | $190.00 | |
Hometown Health
| Professional | $5.09 | $5.09 | $5.09 |
Methsuximide
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.13 | $23.13 | $28.91 | |
Hometown Health
| Professional | $5.09 | $5.09 | $190.00 | |
Hometown Health
| Professional | $5.09 | $5.09 | $5.09 |