| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $80.59 | $80.59 | $80.59 | |
CareFirst
| Professional | $114.40 | $114.40 | $148.72 | |
United
| Professional | $4.99 | $7.59 | $7.59 |
Elevating Leg Rests Pair (For Use With Capped Rental Wheelchair Base) (Special Coverage Instructions Apply. See Cim: 60-9)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $80.59 | $80.59 | $80.59 | |
CareFirst
| Professional | $114.40 | $114.40 | $148.72 | |
United
| Professional | $4.99 | $7.59 | $7.59 |