| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $202.50 | $242.50 | |
Cigna
| Professional | $1.58 | $145.00 | $159.00 | |
Hometown Health
| Professional | $100.00 | $350.00 | $425.00 |
Unspecified Oral Dosage Form, Fda Approved Prescription Antieme
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $1.00 | $202.50 | $242.50 | |
Cigna
| Professional | $1.58 | $145.00 | $159.00 | |
Hometown Health
| Professional | $100.00 | $350.00 | $425.00 |