| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.94 | $18.39 | $19.32 | |
BCBS
| Professional | $19.00 | $19.00 | $19.00 | |
Cigna
| Professional | $9.57 | $9.57 | $14.50 | |
United
| Professional | $6.63 | $9.94 | $13.26 |
U-V Lens Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.94 | $18.39 | $19.32 | |
BCBS
| Professional | $19.00 | $19.00 | $19.00 | |
Cigna
| Professional | $9.57 | $9.57 | $14.50 | |
United
| Professional | $6.63 | $9.94 | $13.26 |