| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $39.50 | $112.50 | |
Health Alliance Plan
| Professional | $25.45 | $26.34 | $34.24 | |
Molina
| Professional | $30.00 | $30.00 | $50.00 |
Unlisted ophthalmological service or procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $39.50 | $112.50 | |
Health Alliance Plan
| Professional | $25.45 | $26.34 | $34.24 | |
Molina
| Professional | $30.00 | $30.00 | $50.00 |