| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $194.16 | $194.16 | $194.16 | |
Kaiser Permanente
| Professional | $219.26 | $219.26 | $219.26 | |
United
| Professional | $124.77 | $187.15 | $224.27 |
General use wheelchair back cushion, width 22 in or greater, any height, including any type mounting hardware
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $194.16 | $194.16 | $194.16 | |
Kaiser Permanente
| Professional | $219.26 | $219.26 | $219.26 | |
United
| Professional | $124.77 | $187.15 | $224.27 |