| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $467.74 | $467.74 | $467.74 |
Medical/Surgical Supplies and Devices-Intraocular Lens
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $467.74 | $467.74 | $467.74 |