| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Professional | $86.93 | $90.21 | $90.21 | |
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Priority Health
| Professional | $104.74 | $104.74 | $104.74 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross
| Professional | $86.93 | $90.21 | $90.21 | |
Cigna
| Professional | $104.74 | $104.74 | $104.74 | |
Priority Health
| Professional | $104.74 | $104.74 | $104.74 |