| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.55 | $58.55 | $64.34 |
Procenta, Per 200 Mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.55 | $58.55 | $64.34 |