| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Hally Health
| Professional | $151.36 | $199.53 | $275.42 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |
Miscellaneous DME supply or accessory, not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Hally Health
| Professional | $151.36 | $199.53 | $275.42 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |