| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.51 | $13.76 | $14.89 | |
Cigna
| Facility | $14.57 | $14.57 | $14.57 | |
Cigna
| Professional | $12.38 | $12.38 | $19.13 | |
United
| Professional | $7.50 | $11.26 | $15.58 |
Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.51 | $13.76 | $14.89 | |
Cigna
| Facility | $14.57 | $14.57 | $14.57 | |
Cigna
| Professional | $12.38 | $12.38 | $19.13 | |
United
| Professional | $7.50 | $11.26 | $15.58 |