| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $412.99 | $446.74 | $446.74 | |
Cigna
| Facility | $296.00 | $296.00 | $296.00 | |
Cigna
| Professional | $296.00 | $296.00 | $296.00 |
Back Contoured For Pediatric Size Wheelchair Including Fixed Attaching Hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $412.99 | $446.74 | $446.74 | |
Cigna
| Facility | $296.00 | $296.00 | $296.00 | |
Cigna
| Professional | $296.00 | $296.00 | $296.00 |