| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.14 | $158.49 | $239.88 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Medcost
| Facility | $15.14 | $112.20 | $239.88 |
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 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Medcost
| Facility | $15.14 | $112.20 | $239.88 |