| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.13 | $10.44 | $19.09 | |
Cigna
| Professional | $9.44 | $9.44 | $9.44 | |
MVP Health Care
| Professional | $9.44 | $9.44 | $9.44 | |
United
| Professional | $9.82 | $11.96 | $41.05 |
Tint Photochromatic Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.13 | $10.44 | $19.09 | |
Cigna
| Professional | $9.44 | $9.44 | $9.44 | |
MVP Health Care
| Professional | $9.44 | $9.44 | $9.44 | |
United
| Professional | $9.82 | $11.96 | $41.05 |