| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.64 | $19.97 | $19.97 | |
Aetna
| Professional | $13.64 | $14.14 | $19.97 | |
Molina
| Professional | $17.00 | $17.00 | $20.00 |
Injection, tetracycline, up to 250 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.64 | $19.97 | $19.97 | |
Aetna
| Professional | $13.64 | $14.14 | $19.97 | |
Molina
| Professional | $17.00 | $17.00 | $20.00 |