| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Wellpoint
| Professional | $2,511.89 | $2,511.89 | $2,511.89 |
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 | |
Wellpoint
| Professional | $2,511.89 | $2,511.89 | $2,511.89 |