| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $750.00 | $750.00 | |
Aetna
| Professional | $575.28 | $750.00 | $750.00 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |
Prosthetic eye, other type
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $750.00 | $750.00 | |
Aetna
| Professional | $575.28 | $750.00 | $750.00 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |