| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Hally Health
| Professional | $100.00 | $100.00 | $200.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
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
| Professional | $104.74 | $104.74 | $104.74 | |
Hally Health
| Professional | $100.00 | $100.00 | $200.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |