| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.42 | $10.57 | $18.69 | |
Cigna
| Professional | $9.57 | $9.57 | $9.57 | |
Molina
| Professional | $15.38 | $18.72 | $30.00 | |
United
| Professional | $7.79 | $9.94 | $14.99 |
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 | $6.42 | $10.57 | $18.69 | |
Cigna
| Professional | $9.57 | $9.57 | $9.57 | |
Molina
| Professional | $15.38 | $18.72 | $30.00 | |
United
| Professional | $7.79 | $9.94 | $14.99 |