| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.49 | $28.85 | $31.53 | |
Cigna
| Facility | $31.91 | $31.91 | $41.89 | |
Cigna
| Professional | $27.12 | $27.12 | $41.89 | |
United
| Professional | $15.89 | $23.84 | $31.39 |
Manual wheelchair accessory, foam caster tire, any size, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.49 | $28.85 | $31.53 | |
Cigna
| Facility | $31.91 | $31.91 | $41.89 | |
Cigna
| Professional | $27.12 | $27.12 | $41.89 | |
United
| Professional | $15.89 | $23.84 | $31.39 |