| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $81.28 | $83.18 | $102.33 | |
Medica
| Professional | $134.90 | $134.90 | $134.90 | |
Wellmark
| Professional | $112.20 | $112.20 | $112.20 |
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 | $81.28 | $83.18 | $102.33 | |
Medica
| Professional | $134.90 | $134.90 | $134.90 | |
Wellmark
| Professional | $112.20 | $112.20 | $112.20 |