| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $156.41 | $156.41 | $156.41 | |
Priority Health
| Facility | $156.41 | $156.41 | $156.41 |
Compl Oph Xm&Eval General Anes W/Wo Mnpj Globe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $156.41 | $156.41 | $156.41 | |
Priority Health
| Facility | $156.41 | $156.41 | $156.41 |