| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $372.76 | $372.76 | $647.62 |
Level 1 Extraocular, Repair, and Plastic Eye Procedures
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $372.76 | $372.76 | $647.62 |