| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $4,947.39 | $4,947.39 | $8,169.64 |
Level 4 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 | $4,947.39 | $4,947.39 | $8,169.64 |