| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $48.00 | $48.00 | $48.00 | |
Pacific Source
| Facility | $37.20 | $37.20 | $37.20 | |
Providence
| Professional | $71.75 | $71.75 | $2,250,000.00 |
Not Otherwise Classified Single Vision Lens
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $48.00 | $48.00 | $48.00 | |
Pacific Source
| Facility | $37.20 | $37.20 | $37.20 | |
Providence
| Professional | $71.75 | $71.75 | $2,250,000.00 |