| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.84 | $17.66 | $18.86 | |
Cigna
| Facility | $20.13 | $20.13 | $20.13 | |
Cigna
| Professional | $17.11 | $17.11 | $17.11 | |
United
| Professional | $9.50 | $14.26 | $19.80 |
Drive belt for power wheelchair, replacement only
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.84 | $17.66 | $18.86 | |
Cigna
| Facility | $20.13 | $20.13 | $20.13 | |
Cigna
| Professional | $17.11 | $17.11 | $17.11 | |
United
| Professional | $9.50 | $14.26 | $19.80 |