| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.24 | $15.24 | $158.00 | |
Cigna
| Professional | $449.45 | $449.45 | $449.45 | |
Martin's Point
| Professional | $15.24 | $15.24 | $158.00 |
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 | $15.24 | $15.24 | $158.00 | |
Cigna
| Professional | $449.45 | $449.45 | $449.45 | |
Martin's Point
| Professional | $15.24 | $15.24 | $158.00 |