| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $180.13 | $180.13 | $180.13 | |
HMSA
| Professional | $500.00 | $523.55 | $523.55 | |
Kaiser Permanente
| Professional | $50.00 | $50.00 | $50.00 |
Back, planar, for pediatric size wheelchair including fixed attaching hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $180.13 | $180.13 | $180.13 | |
HMSA
| Professional | $500.00 | $523.55 | $523.55 | |
Kaiser Permanente
| Professional | $50.00 | $50.00 | $50.00 |