| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $81.84 | $81.84 | $81.84 | |
Medcost
| Facility | $68.00 | $69.87 | $115.59 | |
Wellcare
| Facility | $396.60 | $396.60 | $396.60 |
Lmtd Oph Xm&Eval General Anes W/Wo Mnpj Globe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $81.84 | $81.84 | $81.84 | |
Medcost
| Facility | $68.00 | $69.87 | $115.59 | |
Wellcare
| Facility | $396.60 | $396.60 | $396.60 |