| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $123.77 | $157.08 | $186.89 | |
United
| Facility | $1,450.00 | $1,450.00 | $1,450.00 |
Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $123.77 | $157.08 | $186.89 | |
United
| Facility | $1,450.00 | $1,450.00 | $1,450.00 |