| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.15 | $39.29 | $39.47 | |
Cigna
| Facility | $39.01 | $39.01 | $39.01 | |
Cigna
| Professional | $33.15 | $33.15 | $51.20 | |
United
| Professional | $19.89 | $33.13 | $48.70 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.15 | $39.29 | $39.47 | |
Cigna
| Facility | $39.01 | $39.01 | $39.01 | |
Cigna
| Professional | $33.15 | $33.15 | $51.20 | |
United
| Professional | $19.89 | $33.13 | $48.70 |