| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.20 | $239.88 | $239.88 | |
Cigna
| Professional | $562.34 | $562.34 | $562.34 | |
Molina
| Professional | $19.95 | $19.95 | $79.43 |
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 | $112.20 | $239.88 | $239.88 | |
Cigna
| Professional | $562.34 | $562.34 | $562.34 | |
Molina
| Professional | $19.95 | $19.95 | $79.43 |