| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.00 | $22.50 | |
Horizon BCBS
| Professional | $14.42 | $14.42 | $14.42 |
Drug confirmation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.00 | $22.50 | |
Horizon BCBS
| Professional | $14.42 | $14.42 | $14.42 |