| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $142.65 | $165.18 | $308.50 |
Compl Oph Xm&Eval General Anes W/Wo Mnpj Globe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $142.65 | $165.18 | $308.50 |