| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.38 | $21.38 | $26.72 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Sanford Health Plan
| Professional | $25.43 | $42.38 | $42.38 |
Assay of phenothiazine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.38 | $21.38 | $26.72 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Sanford Health Plan
| Professional | $25.43 | $42.38 | $42.38 |