| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $4,577.22 | $4,577.22 | $4,577.22 | |
United
| Facility | $2,595.00 | $2,595.00 | $2,595.00 |
Compl Oph Xm&Eval General Anes W/Wo Mnpj Globe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $4,577.22 | $4,577.22 | $4,577.22 | |
United
| Facility | $2,595.00 | $2,595.00 | $2,595.00 |