| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $60.26 | $87.10 | $147.91 | |
United
| Facility | $1,737.80 | $2,570.40 | $2,570.40 |
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 | $60.26 | $87.10 | $147.91 | |
United
| Facility | $1,737.80 | $2,570.40 | $2,570.40 |