| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,636.98 | $4,945.87 | $6,385.87 | |
Providence
| Facility | $3,636.98 | $4,945.87 | $8,711.84 |
Level 4 Extraocular, Repair, and Plastic Eye Procedures
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,636.98 | $4,945.87 | $6,385.87 | |
Providence
| Facility | $3,636.98 | $4,945.87 | $8,711.84 |