| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.41 | $19.48 | $20.72 | |
Cigna
| Facility | $20.72 | $20.72 | $27.20 | |
Cigna
| Professional | $17.61 | $17.61 | $27.20 | |
United
| Professional | $10.44 | $15.67 | $19.16 |
Manual Wheelchair Accessory Solid (Rubber/Plastic) Caster Tire (Removable) Any Size Replacement Only Each. (Desc Revised 1/1/2017)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.41 | $19.48 | $20.72 | |
Cigna
| Facility | $20.72 | $20.72 | $27.20 | |
Cigna
| Professional | $17.61 | $17.61 | $27.20 | |
United
| Professional | $10.44 | $15.67 | $19.16 |