| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $212.00 | $268.88 | $268.88 |
Special Eye Exam Initial
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $212.00 | $268.88 | $268.88 |