| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $169.82 | $186.21 | $263.03 | |
Health Partners
| Facility | $169.82 | $169.82 | $208.93 | |
Medica
| Facility | $63.10 | $104.71 | $165.96 |
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 |
|---|---|---|---|---|---|
Cigna
| Facility | $169.82 | $186.21 | $263.03 | |
Health Partners
| Facility | $169.82 | $169.82 | $208.93 | |
Medica
| Facility | $63.10 | $104.71 | $165.96 |