| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.10 | $27.10 | $27.10 | |
Aetna
| Professional | $16.68 | $17.29 | $17.48 | |
Cigna
| Facility | $17.29 | $17.29 | $17.29 | |
Cigna
| Professional | $17.29 | $17.29 | $17.29 |
Lidocaine 70 mg/tetracaine 70 mg, per patch
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.10 | $27.10 | $27.10 | |
Aetna
| Professional | $16.68 | $17.29 | $17.48 | |
Cigna
| Facility | $17.29 | $17.29 | $17.29 | |
Cigna
| Professional | $17.29 | $17.29 | $17.29 |