| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $239.88 | $407.38 | $407.38 | |
Cigna
| Facility | $295.12 | $295.12 | $295.12 | |
Cigna
| Professional | $251.19 | $295.12 | $302.00 |
Back, contoured, for pediatric size wheelchair including fixed attaching hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $239.88 | $407.38 | $407.38 | |
Cigna
| Facility | $295.12 | $295.12 | $295.12 | |
Cigna
| Professional | $251.19 | $295.12 | $302.00 |