| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $66.55 | $66.55 | $66.55 | |
Kaiser Permanente
| Professional | $73.66 | $73.66 | $73.66 | |
United
| Professional | $42.77 | $64.16 | $64.16 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $66.55 | $66.55 | $66.55 | |
Kaiser Permanente
| Professional | $73.66 | $73.66 | $73.66 | |
United
| Professional | $42.77 | $64.16 | $64.16 |