| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $503.29 | $503.29 | $503.29 | |
Aetna
| Professional | $503.29 | $503.29 | $503.29 | |
Medica
| Facility | $394.10 | $503.29 | $503.29 |
Custom fabricated wheelchair seat cushion, any size
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $503.29 | $503.29 | $503.29 | |
Aetna
| Professional | $503.29 | $503.29 | $503.29 | |
Medica
| Facility | $394.10 | $503.29 | $503.29 |