| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.81 | $15.81 | $15.81 | |
Aetna
| Professional | $13.81 | $13.81 | $15.81 | |
Molina
| Professional | $99.78 | $99.78 | $99.78 |
Injection, tetracycline, up to 250 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.81 | $15.81 | $15.81 | |
Aetna
| Professional | $13.81 | $13.81 | $15.81 | |
Molina
| Professional | $99.78 | $99.78 | $99.78 |