| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.34 | $10.44 | $19.53 | |
Cigna
| Professional | $9.44 | $9.44 | $9.44 | |
Molina
| Professional | $16.03 | $17.52 | $60.00 | |
United
| Professional | $7.69 | $9.82 | $14.80 |
Tint Photochromatic Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.34 | $10.44 | $19.53 | |
Cigna
| Professional | $9.44 | $9.44 | $9.44 | |
Molina
| Professional | $16.03 | $17.52 | $60.00 | |
United
| Professional | $7.69 | $9.82 | $14.80 |