| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $275.70 | $275.70 | $275.70 | |
Cigna
| Facility | $226.63 | $226.63 | $226.63 | |
Cigna
| Professional | $192.64 | $192.64 | $226.63 |
Seat, contoured, for pediatric size wheelchair including fixed attaching hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $275.70 | $275.70 | $275.70 | |
Cigna
| Facility | $226.63 | $226.63 | $226.63 | |
Cigna
| Professional | $192.64 | $192.64 | $226.63 |