| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.14 | $158.49 | $239.88 | |
Cigna
| Professional | $446.68 | $446.68 | $446.68 | |
Medica
| Facility | $27.54 | $27.54 | $27.54 | |
Medica
| Professional | $107.15 | $107.15 | $107.15 |
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 | $15.14 | $158.49 | $239.88 | |
Cigna
| Professional | $446.68 | $446.68 | $446.68 | |
Medica
| Facility | $27.54 | $27.54 | $27.54 | |
Medica
| Professional | $107.15 | $107.15 | $107.15 |