| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $90.80 | $90.80 | $104.42 | |
Cigna
| Professional | $57.98 | $58.55 | $72.47 | |
Medica
| Facility | $10,216.79 | $10,216.79 | $10,216.79 |
Procenta, per 200 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $90.80 | $90.80 | $104.42 | |
Cigna
| Professional | $57.98 | $58.55 | $72.47 | |
Medica
| Facility | $10,216.79 | $10,216.79 | $10,216.79 |