| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $36.40 | $112.50 | |
Medcost
| Facility | $54.00 | $54.00 | $54.00 |
Unlisted ophthalmological service or procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $36.40 | $112.50 | |
Medcost
| Facility | $54.00 | $54.00 | $54.00 |