| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.00 | $21.00 | $26.25 | |
Medcost
| Professional | $21.09 | $21.09 | $21.09 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Doxepin
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.00 | $21.00 | $26.25 | |
Medcost
| Professional | $21.09 | $21.09 | $21.09 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |