| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $102.97 | $135.15 | $357.26 | |
Medica
| Facility | $124.26 | $234.00 | $368.66 | |
Midlands
| Facility | $175.66 | $316.97 | $342.45 |
Compl Oph Xm&Eval General Anes W/Wo Mnpj Globe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $102.97 | $135.15 | $357.26 | |
Medica
| Facility | $124.26 | $234.00 | $368.66 | |
Midlands
| Facility | $175.66 | $316.97 | $342.45 |