| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $783.67 | $783.67 | $783.67 | |
Providence
| Professional | $783.67 | $783.67 | $783.67 |
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $783.67 | $783.67 | $783.67 | |
Providence
| Professional | $783.67 | $783.67 | $783.67 |