| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $239.88 | $239.88 | $288.40 | |
Cigna
| Facility | $181.97 | $181.97 | $181.97 | |
Cigna
| Professional | $154.88 | $181.97 | $186.21 |
Back, planar, for pediatric size wheelchair including fixed attaching hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $239.88 | $239.88 | $288.40 | |
Cigna
| Facility | $181.97 | $181.97 | $181.97 | |
Cigna
| Professional | $154.88 | $181.97 | $186.21 |