| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $54.95 | $102.33 | $194.98 | |
United
| Facility | $851.14 | $1,071.52 | $4,073.80 |
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; limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $54.95 | $102.33 | $194.98 | |
United
| Facility | $851.14 | $1,071.52 | $4,073.80 |