| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $125.89 | $229.09 | $229.09 | |
Cigna
| Facility | $229.09 | $229.09 | $229.09 | |
Cigna
| Professional | $100.00 | $100.00 | $229.09 |
Wheelchair component or accessory, not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $125.89 | $229.09 | $229.09 | |
Cigna
| Facility | $229.09 | $229.09 | $229.09 | |
Cigna
| Professional | $100.00 | $100.00 | $229.09 |