| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.08 | $70.08 | $70.08 | |
Wellpoint
| Professional | $2,500.00 | $2,500.00 | $2,500.00 |
Miscellaneous Dme Supply Or Accessory Not Otherwise Specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.08 | $70.08 | $70.08 | |
Wellpoint
| Professional | $2,500.00 | $2,500.00 | $2,500.00 |