| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $59.67 | $87.74 | $2,471.00 | |
United
| Facility | $2,545.00 | $2,545.00 | $2,545.00 |
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 | $59.67 | $87.74 | $2,471.00 | |
United
| Facility | $2,545.00 | $2,545.00 | $2,545.00 |