| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.55 | $24.55 | $30.20 | |
Medica
| Facility | $13.80 | $13.80 | $100.00 |
Assay Of Phenothiazine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.55 | $24.55 | $30.20 | |
Medica
| Facility | $13.80 | $13.80 | $100.00 |