| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.17 | $33.15 | $47.30 | |
Cigna
| Facility | $36.21 | $36.21 | $36.21 | |
Cigna
| Professional | $26.43 | $26.43 | $42.48 | |
United
| Professional | $18.30 | $26.98 | $40.65 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.17 | $33.15 | $47.30 | |
Cigna
| Facility | $36.21 | $36.21 | $36.21 | |
Cigna
| Professional | $26.43 | $26.43 | $42.48 | |
United
| Professional | $18.30 | $26.98 | $40.65 |