| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.70 | $7.43 | $7.97 | |
Cigna
| Facility | $8.00 | $8.00 | $8.00 | |
Cigna
| Professional | $6.80 | $6.80 | $10.49 | |
United
| Professional | $4.01 | $6.02 | $8.16 |
Manual wheelchair accessory, tube for pneumatic caster tire, any size, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.70 | $7.43 | $7.97 | |
Cigna
| Facility | $8.00 | $8.00 | $8.00 | |
Cigna
| Professional | $6.80 | $6.80 | $10.49 | |
United
| Professional | $4.01 | $6.02 | $8.16 |