| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $575.44 | $575.44 | $575.44 | |
Cigna
| Facility | $426.58 | $426.58 | $426.58 | |
Cigna
| Professional | $363.08 | $426.58 | $426.58 |
Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $575.44 | $575.44 | $575.44 | |
Cigna
| Facility | $426.58 | $426.58 | $426.58 | |
Cigna
| Professional | $363.08 | $426.58 | $426.58 |