| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.70 | $119.70 | $119.70 |
Heavy-duty shock absorber for heavy-duty or extra heavy-duty power wheelchair, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.70 | $119.70 | $119.70 |