| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.74 | $92.33 | $143.29 | |
United
| Facility | $2,833.00 | $2,833.00 | $2,833.00 |
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; limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $54.74 | $92.33 | $143.29 | |
United
| Facility | $2,833.00 | $2,833.00 | $2,833.00 |