| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $133.00 | $133.00 | $133.00 | |
Cigna
| Facility | $228.57 | $228.57 | $228.57 | |
Cigna
| Professional | $99.89 | $99.89 | $228.57 |
Wheelchair Component Or Accessory Not Otherwise Specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $133.00 | $133.00 | $133.00 | |
Cigna
| Facility | $228.57 | $228.57 | $228.57 | |
Cigna
| Professional | $99.89 | $99.89 | $228.57 |