| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.51 | $0.51 | $0.51 | |
Providence
| Professional | $0.51 | $0.51 | $2,250,000.00 |
Vision Item Or Service Miscellaneous (Revised 12/08/2014)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $0.51 | $0.51 | $0.51 | |
Providence
| Professional | $0.51 | $0.51 | $2,250,000.00 |