| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $403.26 | $564.45 | $564.45 | |
Cigna
| Professional | $766.82 | $766.82 | $766.82 | |
United
| Professional | $311.11 | $611.95 | $777.77 |
Hemi-Wheelchair Fixed Full Length Arms Swing Away Detachable Elevating Leg Rest (Special Coverage Instructions Apply. See Cim: 60-9)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $403.26 | $564.45 | $564.45 | |
Cigna
| Professional | $766.82 | $766.82 | $766.82 | |
United
| Professional | $311.11 | $611.95 | $777.77 |