| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.24 | $2.24 | $3.76 | |
Cigna
| Professional | $2.24 | $2.24 | $2.24 | |
MVP Health Care
| Professional | $2.24 | $2.24 | $2.24 | |
United
| Professional | $2.24 | $2.24 | $2.37 |
Injection Amitriptyline Hcl Up To 20 Mg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.24 | $2.24 | $3.76 | |
Cigna
| Professional | $2.24 | $2.24 | $2.24 | |
MVP Health Care
| Professional | $2.24 | $2.24 | $2.24 | |
United
| Professional | $2.24 | $2.24 | $2.37 |