| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $105.84 | $105.84 | $105.84 | |
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |
Heavy-duty shock absorber for heavy-duty or extra heavy-duty manual wheelchair, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $105.84 | $105.84 | $105.84 | |
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |