| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.38 | $21.38 | $26.72 | |
Medcost
| Professional | $14.56 | $14.56 | $21.19 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Phenothiazine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.38 | $21.38 | $26.72 | |
Medcost
| Professional | $14.56 | $14.56 | $21.19 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |