| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $85.25 | $119.87 | $328.00 | |
Medica
| Facility | $1.14 | $4.76 | $25.27 |
Drugs Requiring Specific Ident - Drugs Requiring Detailed Coding
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $85.25 | $119.87 | $328.00 | |
Medica
| Facility | $1.14 | $4.76 | $25.27 |