| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,859.43 | $3,859.43 | $3,859.43 |
Level 4 Extraocular, Repair, and Plastic Eye Procedures
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,859.43 | $3,859.43 | $3,859.43 |