| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.24 | $112.68 | $241.71 | |
Cigna
| Professional | $10.69 | $10.69 | $10.69 | |
Medica
| Facility | $1.00 | $100.00 | $100.00 | |
Medica
| Professional | $108.39 | $108.39 | $108.39 |
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 | $112.68 | $241.71 | |
Cigna
| Professional | $10.69 | $10.69 | $10.69 | |
Medica
| Facility | $1.00 | $100.00 | $100.00 | |
Medica
| Professional | $108.39 | $108.39 | $108.39 |