| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.68 | $112.68 | $112.68 | |
Premera BCBS
| Professional | $10,000.00 | $10,000.00 | $10,000.00 | |
Providence
| Professional | $10,000.00 | $10,000.00 | $10,000.00 |
Vision supply, accessory and/or service component of another HCPCS vision code
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.68 | $112.68 | $112.68 | |
Premera BCBS
| Professional | $10,000.00 | $10,000.00 | $10,000.00 | |
Providence
| Professional | $10,000.00 | $10,000.00 | $10,000.00 |