| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.00 | $22.50 | |
Medcost
| Professional | $12.07 | $12.07 | $18.03 |
Drug confirmation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.00 | $22.50 | |
Medcost
| Professional | $12.07 | $12.07 | $18.03 |