| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $30.72 | $30.72 | $31.64 | |
Providence
| Facility | $30.72 | $30.72 | $30.72 | |
Providence
| Professional | $30.72 | $30.72 | $31.64 |
Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from DME PDAC
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $30.72 | $30.72 | $31.64 | |
Providence
| Facility | $30.72 | $30.72 | $30.72 | |
Providence
| Professional | $30.72 | $30.72 | $31.64 |