| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.50 | $61.00 | $750.00 | |
Molina
| Professional | $56.87 | $62.55 | $93.89 | |
Wellpoint
| Professional | $56.87 | $56.87 | $56.87 |
Unlisted ophthalmological service or procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.50 | $61.00 | $750.00 | |
Molina
| Professional | $56.87 | $62.55 | $93.89 | |
Wellpoint
| Professional | $56.87 | $56.87 | $56.87 |