| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Hometown Health
| Professional | $5.35 | $5.35 | $190.00 | |
Hometown Health
| Professional | $5.35 | $5.35 | $5.35 |
Assay Of Phenothiazine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Hometown Health
| Professional | $5.35 | $5.35 | $190.00 | |
Hometown Health
| Professional | $5.35 | $5.35 | $5.35 |